Bilateral and symmetric C1-C2 dumbbell ganglioneuromas associated with neurofibromatosis type 1: A case report

BACKGROUND Ganglioneuroma(GN) is a rare and benign tumor that originates from autonomic nervous system ganglion cells. The most frequently involved sites are the posterior mediastinum, the abdominal cavity, and the retroperitoneal space. It rarely occurs in the cervical area, compressing the spinal cord. Neurofibromatosis type 1(NF-1) is an autosomal dominant inheritance disorder, whose prevalence rate approximates one per 3000.CASE SUMMARY We report an extremely rare case of bilateral and symmetric dumbbell GNs of the cervical spine with NF-1. A 27-year-old man with NF-1 presented with a one-year history of gradually progressive right upper extremity weakness and numbness in both hands. Magnetic resonance imaging showed bilateral and symmetric dumbbell lesions at the C1-C2 levels compressing the spinal cord. We performed total resection of bilateral tumors, and the postoperative histopathological diagnosis of the resected mass was GN. After operation, the preoperative symptoms were gradually relieved without complications. To our knowledge,this is the sixth report of cervical bilateral dumbbell GNs.CONCLUSION In some cases, cervical bilateral dumbbell GNs could be associated with NF-1.The exact diagnosis cannot be obtained before operation, and pathological outcome is the current gold standard. Surgical resection is the most effective option, and disease outcome is generally good after treatment.     

阴道镜对宫颈病变的诊断价值研究

Objective To research the value of colposcopy examination for all kinds of cervical lesions. Methods Analyze the results of 3,258 cases of patients, who have taken the colposcopy examination in our hospital from Jan, 2005 to Jun, 2008. Results Among the 3,258 cases colposcopy examination, there were 458 cases with the abnormal colposcope and having the needle biopsy through the colposcopy,including 137 cases of low degree lesion by the pathological diagnosis, 84 cases of high degree lesion(CIN2～ CIN3) , 18 cases of cervical invasive carcinoma, 79 cases of chronic inflammation, and 150 cases of cervical benign tumor. Conclusion The colposcope picture has higher coincidence rate in the colposcope xgc and the histopathology diagnosis, and is important in finding the cervical cancer, cervical precancerous lesion, human papillomavirus infection and complicated precancerous lesion in the early stage.     

颈椎损伤的X线与CT诊断

Objective To evaluate the diagnosis value of X-ray and CT for cervical spine injury. Methods The clinical data of 50 cases of vertebral spine injuries which were neglected due to missed diagnosis were analyzed retrospectively. Results 50 cases with cervical spine injury, among of them, 27 cases with fracture and/(or) dislocation of the lower cervical vertebrae,9 cases had atlantal fracture,8 cases had atlantoaxial dislocation and 6 cases had the axoid fracture. 24 cases showed abnormality in the lines of vertebral posterior border in the X-ray plain films. 28 cases were diagnosed instabitity,22 cases vertebral canal 0° stricture, 17 cases Ⅰ°stricture, 8 cases Ⅱ°stricture,3 cases Ⅲ° stricture were diagnosed according CT films. 10 cases traumatic cervicales disc herniation. Conclusion X-ray and CT have their own localization for injured cervical vertebraes. We must perform X-ray and CT examination in order to provide overall and reliable information for clinical diagnosis. CT is becoming an indispensible and best modality of choices in the diagnosis of atloaxoid injuries helpful for the surgeon to decide clinical management. The advantages of CT are suggested that this diagnostic modality may be the standard method for the initial evaluation of the cervical spine injury.     

Intrauterine cystic adenomyosis:Report of two cases

BACKGROUND Cystic adenomyosis is a special type of adenomyosis. Its clinical manifestations lack specificity. Pelvic ultrasound and nuclear magnetic resonance imaging can help clarify the diagnosis. Because cystic uterine adenomyosis is rare in clinical work, it can be easily misdiagnosed or its diagnosis can be missed. Early surgical treatment and postoperative drug treatment can alleviate dysmenorrhea,menorrhagia, anemia, and other symptoms.CASE SUMMARY Two cases complained about abnormal vaginal bleeding and were diagnosed with intrauterine cystic adenomyosis by gynecological ultrasound and pathological examination. The clinical manifestations included dysmenorrhea,hypermenorrhea, and a history of cesarean section. Both cases underwent a surgery, and chocolate-like liquid was released from the cystic mass in the uterus and the manifestations were relieved.CONCLUSION Intrauterine cystic adenomyosis could be diagnosed by pathological examination and treated by hysterectomy or hystscopy to release the liquid inside.     

Small cell lung cancer starting with diabetes mellitus: Two case reports and literature review

BACKGROUND Small-cell lung cancer(SCLC)is a type of fatal tumor that is increasing in prevalence.While these are unpleasant facts to consider,it is vitally important to be informed,and it is important to catch the disease early.Typically,lung cancer does not show severe clinical symptoms in the early stage.Once lung cancer has progressed,patients might present with classical symptoms of respiratory system dysfunction.Thus,the prognosis of SCLC is closely related to the early diagnosis of the disease.Ectopic adrenocorticotropic hormone(ACTH)syndrome(EAS)is related to cancer occurrence,especially for SCLC with the presence of Cushing's syndrome,which is dependent on markedly elevated ACTH and cortisol levels.CASE SUMMARY In the current report,we describe two middle-age patients who were originally diagnosed with diabetes mellitus with no classical symptoms of lung cancer.The patients were eventually diagnosed with SCLC,which was confirmed by bronchoscopic biopsy and histopathology.SCLC-associated diabetes was related to EAS,which was an endogenous ACTH-dependent form of Cushing’s syndrome with elevated ACTH and cortisol levels.Multiple organ metastases were found in Patient 1,while Patient 2 retained good health at 2 years follow-up.EAS symptoms including thyroid dysfunction,hypercortisolism and glucose intolerance were all resolved after anticancer treatment.CONCLUSION In conclusion,SCLC might start with diabetes mellitus and increased cortisol and hypokalemia or other EAS symptoms.These complex clinical features were the most significant factors to deteriorate a patient’s condition.Early diagnosis and treatment from clinicians were essential for the anti-cancer treatment for patients with SCLC.     

Japanese encephalitis following liver transplantation: A rare case report

BACKGROUND Japanese encephalitis(JE) is a serious public health concern with a high mortality rate in many Asian countries. For many years, JE virus(JEV) was considered the major cause of viral encephalitis in Asia. Although most JE cases are asymptomatic, the case fatality rate approaches 30%, and approximately 30%–50% of survivors have long-term neurological sequelae. To the best of our knowledge, JEV infection has never been reported following liver transplantation.CASE SUMMARY We report a case of a woman who underwent liver transplantation for autoimmune liver disease but presented with fever and neurological symptoms 13 d after transplantation. Magnetic resonance imaging revealed JEV infection,and positive immunoglobulin M antibody to JEV in blood and cerebrospinal fluid confirmed JE. The patient was treated with antiviral agents, immune regulation,and organ function support. No neurological sequelae were present after 1 year of follow-up.CONCLUSION Imaging and lumbar puncture examination should be performed as soon as possible in patients with fever and central nervous system symptoms after liver transplantation, and the possibility of atypical infection should be considered,which is helpful for early diagnosis and improved prognosis.     

Analysis of amelioration of neurological function on cervical degeneration disease after treatment with cervical spine locking plate

Objective To discuss the clinical effect of treatment with anterior decompression,bone graft and cervical locking plate fixation for cervical degeneration disease.Method 23 patients with cervical spondylotic myelopathy and cervical ossification of the posterior longitudinal ligament have undergone the treatment of anterior cervical spine locking plate fusion,Neurological signs and symptoms were evaluated before and after surgery,and mean follow-up time was 11,3 months.Result In all cases,radiography demonstrated a solid bony fusion,Additional general complications include a large wound hematoma in one and hoarseness in one ,All patients‘ neurological function were improved.Conclusion The clinical effect of treatment with anterior decompression,bone graft and cervical locking plate fixation for cervical degeneration disease is satisfactory.     

Intestinal endometriosis:Diagnostic ambiguities and surgical outcomes

BACKGROUND Endometriosis is a common disease for women of reproductive age. However,when it involves intestines, it is difficult to diagnose preoperatively because its symptoms overlap with other diseases and the results of evaluations can be unspecific. Thus it is important to know the clinical characteristics of intestinal endometriosis and how to exactly diagnose.AIM To analyze patients in whom intestinal endometriosis was diagnosed after surgical treatments, and to evaluate the clinical characteristics of preoperatively misdiagnosed cases.METHODS We retrospectively reviewed the pathologic reports of 30 patients diagnosed as having intestinal endometriosis based on surgical specimens between January2000 and December 2017. We reviewed their clinical characteristics and surgical outcomes.RESULTS Twenty-three(76.6%) patients showed symptoms associated with endometriosis,with dysmenorrhea being the most common(n = 9, 30.0%). Thirteen patients(43.3%) had a history of pelvic surgeries. Ten patients(33.3%) had a history of treatment for endometriosis. Only 4 patients(13.3%) had a diagnosis of endometriosis based on endoscopic biopsy findings. According to preoperative evaluations, 13 patients(43.3%) had an initial diagnosis of pelvic endometriosis and 17 patients(56.6%) were misdiagnosed as having other diseases. The most common misdiagnosis was submucosal tumor in the large intestine(n = 8, 26.7%),followed by malignancies of the colon/rectum(n = 3, 10.0%) and ovary(n = 3,10.0%). According to the Clavien-Dindo classification, 5 complications were grade I or II and 2 complications were grade IIIa. The median follow-up period was 26.9(0.6-132.1) mo, and only 1 patient had a recurrence of endometriosis.CONCLUSION Intestinal endometriosis is difficult to diagnose preoperatively because it mimics various intestinal diseases. Thus, if women of reproductive age have ambiguous symptoms and signs with nonspecific radiologic and/or endoscopic findings,intestinal endometriosis should be included in the differential diagnosis.     

Congenital bronchobiliary fistula: A case report and review of the literature

BACKGROUND Congenital bronchobiliary fistula is a rare developmental abnormality with an abnormal fistula between the respiratory system and biliary tract. The aim of this report is to analyze and summarize the clinical features and experience of diagnosing and treating congenital bronchobiliary fistula(CBBF) occurring in the neonatal period.CASE SUMMARY The onset of symptoms was 3 d after birth in our patient with progressive cyanosis and respiratory distress, and a large amount of green fluid was noticed in her respiratory secretion. We performed computed tomography(CT),fiberoptic bronchoscopy, and cholangiography to make a diagnosis, as well as fistulography with a bronchoscope for the first time. These examinations provided us with valuable images to make a correct diagnosis. The fistula was dissected and removed with excellent results. Surgical removal of the fistula was successful, and the baby recovered well and was discharged. She has been followed for 4 mo without any signs of discomfort.CONCLUSION The main symptom of CBBF is bile-like sputum. CT, bronchoscopy,fistulography, and intraoperative cholangiography can provide important evidence for diagnosis. Surgical resection of the fistula is the first choice of treatment.     

Unexplained abdominal pain due to a fish bone penetrating the gastric antrum and migrating into the neck of the pancreas: A case report

BACKGROUND Ingestion of foreign bodies results in gastrointestinal perforation in approximately 1% of patients,and fish bones are the objects that most commonly lead to bowel perforation. When it does occur,the terminal ileum is the most common site of perforation,followed by the duodenal C-loop. However,involvement of the pancreas is very rare. Because clinical symptoms are nonspecific and gastrointestinal perforation may present as only odynophagia or abdominal pain,a definite preoperative diagnosis and clinical intervention may be delayed.CASE SUMMARY We report the case of a 32-year-old man who presented to our hospital because of abdominal pain that had worsened over 5 d. He had no significant past history except that he had eaten fish 1 wk previously. Upper endoscopy revealed an irregular submucosal tumor on the front wall of the gastric antrum. Endoscopic ultrasonography and computed tomography showed a fish bone penetrating the gastric antrum and migratingin to the neck of the pancreas. The patient underwent laparoscopic surgery and had no complications one week after the operation.CONCLUSION A recent history of foreign body ingestion and imaging examinations are helpful for diagnosis of unexplained abdominal pain caused by foreign bodies.     

Permanent Neurologic Symptoms after Prolonged Epidural Analgesia

Objective: Although transient neurologic symptoms may occur after neuraxial anesthetics with lidocaine, permanent neurologic symptoms (PNS) are unusual after uncomplicated continuous epidural analgesia (CEA). This report demonstrates that PNS may follow CEA uncomplicated by paresthesias, dural puncture, spinal hemorrhage, or intravascular local anesthetic injection; and performed with bupivacaine alone administered at high dosages with vasoconstrictors over a prolonged time period. Case Report: An obstetrical patient developed fixed left L5‐S1 sensorimotor radiculopathy following L5‐S1 level CEA with bupivacaine alone administered at high doses (270 mg) with a vasoconstrictor (epinephrine, 225 mg) over a prolonged time period (62 hours). Conclusions: CEA should be administered at higher lumbar levels for labor analgesia rather than at lumbosacral levels that may require higher volumes and concentrations of local anesthetics with greater potential for local anesthetic neurotoxicity. Local anesthetics with vasoconstrictors should only be used as sentinel markers of unrecognized intravascular entry, rather than as primary local anesthetics during CEA to avoid any potential for ischemic neuropathy.     

4种肿瘤标志物联合检测在宫颈鳞癌患者中的临床应用

目的探讨鳞状细胞癌相关抗原(SCC)、细胞角蛋白CK19(CyFRA21-1)、组织多肽特异抗原(TPS)、癌胚抗原(CEA)在宫颈鳞癌患者中的临床应用。方法分别采用化学发光法测定SCC含量,电化学发光法测定CEA、CyFRA21-1含量,酶联免疫吸附试验测定TPS含量,本研究共检测了65例患者(其中宫颈鳞癌52例,宫颈上皮内癌变13例)和30例健康者的SCC、CyFRA21-1、TPS、CEA的水平,数据用SPSS软件进行分析。结果宫颈癌组SCC、CyFRA21-1、TPS、CEA水平和敏感性均高于宫颈上皮内癌变组和健康对照组,差异具有统计学意义(P<0.05);SCC联合CyFRA21-1、TPS、CEA检测可显著提高宫颈鳞癌的敏感性、特异性及诊断的准确性。结论 SCC联合CyFRA21-1、TPS、CEA检测有助于宫颈鳞癌的辅助诊断,在临床上有一定的应用价值。     

抗CV2自身免疫性脑炎合并重症肌无力一例 并文献复习

目的：探讨CV2抗体相关神经系统副肿瘤综合征（PNS）的临床特征及预后特点。方法：本文报道一例 CV2抗体相关PNS患者,结合文献进行回顾性分析。结果：本文患者首诊时表现为小脑性共济失调和边缘 性脑炎的症状,CV2抗体阳性,全身PET-CT提示胸腺占位,病理活检示胸腺囊肿,胸腺切除术后症状迅速好 转。但2年后患者出现全身无力,CV2抗体、AChR抗体及Titin抗体阳性,诊断为重症肌无力,经免疫治疗后 明显好转。既往报道的CV2抗体相关神经系统副肿瘤综合征患者共92例,常见的临床症状包括周围神经 病、舞蹈症、小脑性共济失调、自身免疫性脑炎、视神经炎或视网膜病变和肌无力综合征,常见的肿瘤类型包 括小细胞肺癌和胸腺瘤。结论：CV2抗体相关PNS临床表现多样,伴胸腺占位时主要表现为肌无力、边缘性 脑炎和小脑性共济失调。复发性PNS十分罕见,当排除肿瘤复发时给予免疫治疗,预后相对较好。     

肿瘤标志物在霉菌性胃溃疡及溃疡型胃癌鉴别诊断中的应用价值

目的分析几种典型的血清肿瘤标志物在霉菌性胃溃疡与溃疡型胃癌中的变化,以探讨其临床鉴别诊断价值。方法根据手术后病理结果,122例胃溃疡患者分为溃疡型胃癌组（n=75）、胃癌合并霉菌组（n=4）及霉菌性胃溃疡组（n=43）,55例健康成人设为健康对照组。采集静脉血,分离血清。采用电化学发光法检测血清癌抗原72-4（CA72-4）、癌抗原199（CA19-9）、癌抗原242（CA24-2）、癌胚抗原（CEA）。日立7170全自动生化分析仪上进行血清唾液酸（SA）值和甘氨酰脯氨酸二肽氨基肽酶（GPDA）活力测定。结果1）溃疡型胃癌组血清CA724、CA19-9、CA24-2、CEA、SA水平分别为（49．85&#177;10．36）U／L、（59．31&#177;3．89）U／L、（38．77&#177;12．56）U／L、（5．33&#177;2．94）μg／L及（85．12&#177;10．86）mg／dL,胃癌合并霉菌组分别为（48．98&#177;11．22）U/L、（60．13&#177;4．72）U／L、（36．92&#177;9．97）U／L、（5．38&#177;7．22）μg／L及（85．16&#177;9．96）mg／dL,均显著高于健康对照组和霉菌性胃溃疡组;溃疡型胃癌组与胃癌合并霉菌组GPDA水平分别为（48．09&#177;15．02）U／L及（48．22&#177;13．51）U／L,显著低于健康对照组和霉菌性胃溃疡组,差异均有统计学意义（P〈0．01）。2）溃疡型胃癌组血清CA72-4、CA19-9、CA24-2、CEA、SA及GPDA阳性检出率分别为24．00％、29．33％、20．00％、41．33％、65．33％及72．00％,均分别显著高于健康对照组和霉菌性胃溃疡组,差异均有统计学意义（P〈0．01）,SA＋GPDA联合检测阳性检出率达到78．67％。结论CA72-4、CA19-9、CA24-2、CEA、SA和GPDA等6种血清肿瘤标志物检测对霉菌性胃溃疡、溃疡型胃癌具有鉴别诊断价值,在胃溃疡病因难以确定、选择治疗方案时,检测具有高度特异性及敏感性的血清肿瘤标志物,特别是血清肿瘤标志物联合检测对疾病的临床处理及预后转归具有重要的参考意义。     

肿瘤标志物在消化系统肿瘤早期诊断中的应用

目的探讨血清肿瘤标志物在消化系统恶性肿瘤中的应用价值。方法采用电化学发光仪检测224例消化系统恶性肿瘤患者和103例健康对照者血清中六种肿瘤标志物:甲胎蛋白(AFP),糖类抗原125(CA-125),糖类抗原199(CA-199),癌胚抗原(CEA),细胞角蛋白 21-1(CYFRA21-1)和转铁蛋白(Ferritin),对比两组检测结果的差异及其灵敏度和特异度。结果①肿瘤组六种肿瘤标志物AFP,CA125,CA199,CEA,CYFRA21-1和Ferritin水平均高于对照组(Z=-2.174,-1.917,-3.012,-2.122,-1.954,-2.997;P=0.037,0.000,0.000,0.000,0.000,0.000)。②消化肿瘤组中AFP,CA125,CA199,CEA,CYFRA21-1和Ferritin六种标志物阳性率较对照组差异均有统计学显著性意义(χ2=31.23,23.63,36.89,29.12,30.11,27.18;P=0.002,0.000,0.000,0.000,0.000,0.000),CA-199阳性率最高(50.45%)。③六种血清肿瘤标记物在消化系统肿瘤中的灵敏度、特异度和准确度不同,消化系统肿瘤以CEA+CA-199+AFP和CEA+CA-125+CA-199联合较与其他标志物联合敏感度(70.98%,70.98%),特异度(92.23%,85.44%)更高。结论血清肿瘤标志物对消化系统恶性肿瘤的诊断具有积极的作用,其可提高恶性肿瘤的早期检出率。     

血清癌胚抗原、鳞状细胞癌抗原、调节性T细胞水平变化在评估宫颈癌患者术后放疗疗效中的应用

目的分析血清癌胚抗原(carcinoembryonic antigen,CEA)、鳞状细胞癌抗原(squamous cell carcinoma antigen,SCC-Ag)、调节性T细胞(Treg)在评估宫颈癌患者术后放疗疗效中的应用效果。方法选择2017年3月至2019年2月我院收治的宫颈癌术后患者123例,均给予调强放疗。放疗前后检测血清CEA、SCC-Ag、Treg,根据WHO实体瘤疗效评价标准(RECIST)分为有效组84例、稳定组26例和进展组13例,分析血清CEA、SCC-Ag、Treg与放疗的关系。结果放疗后,宫颈癌患者血清CEA、SCC-Ag、Treg低于放疗前(P<0.01)。血清CEA、SCC-Ag、Treg水平有效组低于稳定组和进展组,稳定组低于进展组(P<0.05);血清CEA、SCC-Ag、Treg下降百分比有效组高于稳定组和进展组,稳定组高于进展组(P<0.01)。血清CEA、SCC-Ag、Treg下降百分比与放疗疗效呈正相关(P<0.05)。结论血清CEA、SCC-Ag、Treg水平变化与宫颈癌术后患者放疗疗效密切相关,可作为评估宫颈癌术后放化疗的有效指标。     

SCC、CEA、CA125化学发光法联合检测在肺癌早期诊断中的价值

目的探讨鳞状细胞癌抗原(SCC)、癌胚抗原(CEA)、糖类抗原125(CA125)联合检测在肺癌早期诊断中的临床应用效果。方法采用全自动化化学发光免疫分析仪对早期肺癌患者、肺部良性疾病患者及健康体检者血清SCC、CEA及CA125浓度进行测定。结果肺癌组3项肿瘤标志物浓度显著高于良性疾病组及对照组(P0.05);腺癌患者CEA和CA125测定浓度均显著高于鳞癌和小细胞癌患者(P0.05),鳞癌患者SCC测定浓度明显高于腺癌及小细胞肺癌患者(P0.05);3项肿瘤标志物联合检测的灵敏度、特异度、阳性预测值和阴性预测值均显著优于单项检测,差异有统计学意义(P0.05)。结论 SCC、CEA及CA125联合检测可用于肺癌早期诊断,具有推广价值。     

华蟾素注射液和艾迪注射液治疗晚期肺癌的对比研究

目的探讨华蟾素注射液和艾迪注射液对晚期肺癌的干预作用。方法将60例晚期肺癌患者随机分为2组,华蟾素组30例,采用华蟾素注射液加基础治疗;艾迪组30例,采用艾迪注射液加基础治疗。分别观察临床综合疗效、症候总积分、主要症状积分、Karnofsky评分,以及肿瘤标志物(CEA、CA125)的变化。1个月为1个疗程,共观察3个疗程。结果治疗后,在临床综合疗效和症候总积分改善方面,2组比较,差异无显著性;在肺癌气阴两虚证主要症状积分、Karnofsky评分,以及肿瘤标志物水平改善方面,艾迪组优于华蟾素组(P<0.05)。结论针对晚期肺癌气阴两虚证患者,华蟾素注射液和艾迪注射液均有较好的疗效,但是,由于艾迪注射液是多成分的中药复方制剂,更加适合于晚期肺癌气阴两虚证患者。     

Superior vena cava obstruction: is stenting necessary?

No therapy is currently available for patients with recurrent vascular obstruction of the superior vena cava (SVC) caused by tumor regrowth after chemotherapy or radiation therapy. Intravascular stenting is a new option for the treatment of vena cava syndrome. Forty cancer patients with SVC syndrome (SVCS) were evaluated by computed tomography (CT) and venography. The SVC or its tributaries were stenosed or thrombosed in all patients. The etiology was malignant in all but 2 cases: non-small-cell lung carcinoma (n = 28), mediastinal nodal metastasis (n = 5), lymphoma (n = 2), pleural mesothelioma (n = 2), small-cell lung carcinoma (n = 1), and postradiation fibrous mediastinitis (n = 2). Stenting was achieved in 39 of the 40 patients, and clinical symptoms subsided in 92%. Stents remained patent in 36 of these 39 patients throughout a mean follow-up of 24 weeks (range 3 days to 24 months). SVC stenting is safe, effective and allows rapid cure of SVCS and port catheter implantation in patients in poor health.     

肿瘤标志物指数用于术前非小细胞肺癌的预后评估

目的评价基于癌胚抗原(CEA)和细胞角蛋白片段19(Cyfra21-1)的肿瘤标志物指数(TMI)对临床I期非小细胞肺癌(NSCLC)预后评估的意义。方法对351例术前为临床I期、病理类型均为腺癌或鳞癌的NSCLC病例进行回顾性分析,随访时间≥5年。比较血清CEA和Cyfra 21-1水平以及TMI与患者生存率的关系,并用单因素和多因素分析其风险比(95%可信区间)[OR(95%CI)]。结果血清CEA水平正常组[(5.14±1.65)ng/mL,n=266]和升高组[(45.88±27.78)ng/mL,n=85]5年生存率分别为89.85%和8.24%(χ2=299.30,P<0.01);血清Cyfra21-1水平升高组[(4.85±1.41)ng/mL,n=95]和正常组[(2.23±0.68)ng/mL,n=256]5年生存率分别为15.96%和90.27%(χ2=255.70,P<0.01)。TMI≤1.0组的5年生存率为96.81%,TMI>1.0组的5年生存率仅为3.02%(χ2=461.13,P<0.01)。单因素分析OR(95%CI)为104.15(48.600,223.218),P<0.01,多因素分析为107.435(49.722,232.138),P<0.01,均显示TMI作为预后判断的独立影响因素意义显著。结论 TMI可用于NSCLC的预后评估和治疗参考。