临床病理学因素、c-MET 对Ⅰ B 期非小细胞 肺癌切除术患者预后的影响

Effect of clinicopathological risk factors and c-MET over-expression on prognosis of patients undergoing resection of stage ⅠB non-small cell lung cancer

摘要:

目的 探讨多发性临床病理学危险因素和c-MET 过表达对Ⅰ B 期非小细胞肺癌（NSCLC）切 除术患者预后的影响。方法 回顾性分析118 例Ⅰ B 期NSCLC 切除术患者的临床资料。采用Kaplan-Meier 法分析其生存率，Cox 模型分析预后及复发的影响因素。结果 年龄>64 岁、吸烟史、低分化、胸膜受累、 脉管受侵、c-MET 阳性为Ⅰ B期NSCLC 患者预后生存的影响因子（P <0.05）。脉管受侵与胸膜受累、脉管 受侵与c-MET 阳性共存为Ⅰ B 期NSCLC 患者无进展生存期（PFS）、特异性生存率（CSS）的独立影响因 素（P <0.05）。脉管受侵与低分化、低分化与c-MET 共存为Ⅰ B 期NSCLC 患者PFS、总生存率（OS）的 独立影响因素（P <0.05）。c-MET 阳性为局部复发的危险因素（P <0.05），而脉管受侵为远处转移的危险因 素（P <0.05）。结论 脉管受侵和c-MET 阳性表达为Ⅰ B 期NSCLC 患者预后的独立危险因素，具有多种 临床病理学因素的患者的生存率低于单一因素的患者，建议有≥ 2 种临床病理学因素的患者接受术后辅助 化疗。

Abstract:

Objective To investigate the effect of multiple clinicopathological risk factors and c-MET over-expression on prognosis of the patients undergoing resection of stage ⅠB non-small cell lung cancer (NSCLC). Methods Totally 118 patients with stage ⅠB NSCLC undergoing surgical resection were analyzed retrospectively. The clinicopathological factors and c-MET expression were analyzed. Kaplan-Meier method was used to analyze the survival rate. Cox model was used for analysis of the influencing factors of prognosis and recurrence. Results Age (>64 years), smoking history, poor differentiation, pleural involvement, vascular invasion, and c-MET positivity were the factors influencing the prognosis of NSCLC in stage ⅠB (P < 0.05). Coexistence of vascular invasion and pleural involvement, vascular invasion and c-MET positivity were the independent factors influencing progression-free survival (PFS) and cancer-specific survival (CSS) (P < 0.05). Coexistence of vascular invasion and low differentiation, low differentiation and c-MET were the independent factors influencing PFS and overall survival of the patients with stage ⅠB NSCLC (P < 0.05). C-MET positivity was the risk factor for local recurrence (P < 0.05), while vascular invasion was the risk factor for distant metastasis (P < 0.05). Conclusions Vascular invasion and c-MET positive expression are the independent risk factors for prognosis of the patients with stage ⅠB NSCLC. The survival rate of the patients with multiple clinicopathological factors is significantly lower than that of the patients with a single factor. It is suggested that the patients with two or more clinicopathological factors accept adjuvant chemotherapy.