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目的分析肺部多发病灶患者的外科治疗效果,为临床诊疗提供依据。方法选择2012年5月至2016年4月我院胸外科61例临床资料保存完整且术前临床诊断为同时性多原发非小细胞肺癌(SMPLC)的病例,对这些患者的临床病理学特征、外科治疗及术后生存情况进行回顾性分析。结果 61例肺部多发病灶患者中,47例存在2处或以上恶性病灶,10例存在1处恶性病灶,4例病灶全为良性。41例患者确诊为SMPLC,1年和3年总生存率分别为97.0%和77.5%。肿瘤最大直径越小(χ~2=10.918,P=0.012)、病灶实性成分越少(χ~2=10.754,P=0.005)、无淋巴结转移(χ~2=10.234,P=0.001)以及TNM分期越早(χ~2=12.068,P=0.007)的SMPLC患者预后越好。结论对于肺部多发病灶患者,若考虑SMPLC可能性大且胸部CT无纵隔淋巴结转移,建议首选手术治疗。
Objective To analyze the surgical treatment of patients with multiple lung lesions and provide the basis for clinical diagnosis and treatment. Methods From May 2012 to April 2016, 61 patients with complete and preoperative clinical diagnosis of multiple non-small cell lung cancer (SMPLC) in our department of thoracic surgery were enrolled in this study. The clinicopathological features , Surgical treatment and postoperative survival were analyzed retrospectively. Results Of the 61 patients with multiple pulmonary lesions, 47 had 2 or more malignant lesions, 10 had 1 malignant lesions and 4 had benign lesions. Forty-one patients were diagnosed as SMPLC. The 1-year and 3-year overall survival rates were 97.0% and 77.5%, respectively. The largest diameter of tumor was smaller (χ ~ 2 = 10.918, P = 0.012), and the lesser of solid component (χ ~ 2 = 10.754, P = 0.005) and no lymph node metastasis (χ ~ 2 = 10.234, P = 0.001) SMPLC patients with a higher TNM stage (χ ~ 2 = 12.068, P = 0.007) had better prognosis. Conclusions For patients with multiple lung lesions, surgical treatment is the first choice if SMPLC is considered to be highly likely and chest CT has no mediastinal lymph node metastases.