肺气肿对早期肺癌手术患者预后的影响

目的:探讨肺气肿与早期肺癌患者肺切除术后长期预后、死亡率和术后并发症之间的关系.方法:回顾性分析2010年01月至2014年12月在我院行手术治疗的非小细胞肺癌(non-small cell lung cancer,NSCLC)患者364例.采集患者人口学、疾病特征、手术方式、手术相关并发症和随访资料.选择术前2周内拍...

Effect of emphysema on prognosis of patients undergoing surgery for early-stage lung cancer

Objective:To investigate the relationship between emphysema and long-term prognosis,mortality and postoperative complications in patients with early lung cancer after pneumonectomy.Methods:364 patients with NSCLC admitted to our Hospital from January 2010 to December 2014 were retrospectively analyzed.The demography,disease characteristics,operation methods,operation related complications and follow-up data were collected.The whole lung CT images taken within 2 weeks before operation were selected,and the percentage of low attenuation area(LAA%)was analyzed by pulmo image analysis software.The formula was LAA%=lung low attenuation area/whole lung volume×100%.LAAs>10%was defined as emphysema.Results:63 patients(17.3%)had emphysema.The 5-year overall survival rates of non-emphysema group and emphysema group were 89.0%and 61.3%(P<0.001),respectively.The 5-year recurrence free survival rates were 81.0%and 51.7%(P<0.001),respectively.Multivariate Cox regression analysis showed that the presence of emphysema,higher smoking index and higher histological grade were independent predictors of poor overall survival rate(P<0.05),while the presence of emphysema,higher smoking index,lower FVC%,higher histological grade and pleural infiltration were independent predictors of poor recurrence rate(P<0.05).The incidence of pneumonia requiring antibiotic treatment(P=0.001)and supraventricular tachycardia requiring drug treatment(P=0.026)in emphysema group were higher than those in non-emphysema group in postoperative Clavien-Dindo system classification≥Ⅱ.Conclusion:Emphysema affects the long-term prognosis and postoperative complications of patients with early lung cancer.It is recommended that preoperative CT scan be used to evaluate emphysema in patients with lung cancer.