Analysis On Clinicopathological Characteristics And Prognostic Factors Of Multiple Primary Lung Cancer

Objective: To summarize and analyze the clinical and pathological data of patients with multiple primary lung cancers,and explore the clinical and pathological characteristics and prognostic factors of patients with multiple primary lung cancers.Methods: A retrospective analysis of 2115 lung cancer patients diagnosed in our hospital from January 2013 to January 2018.Cases were screened after inclusion and exclusion criteria,and clinical and pathological data of multiple primary lung cancer patients were collected and summarized(clinical data: age,Gender,history of heavy smoking,presence or absence of respiratory symptoms,serum tumor markers,multiple primary lung adenocarcinomas at the same time/different time,presence or absence of postoperative adjuvant chemotherapy,with or without other underlying diseases,surgical methods;pathological data: total number of lesions,maximum diameter of largest lesions,lesions Whether it is located in the same lung lobe,whether the lesion is located on the same side of the lung,whether there is N1 lymph node metastasis,the highest TNM staging),and follow-up;follow-up methods such as telephone follow-up and outpatient case data,etc.,accurately calculate their survival time;adopt Kaplan-Meier univariate analysis and COX proportional hazards regression model were used to analyze the influencing factors that may be related to the prognosis.The univariate test used the Log Rank(Mantel-Cox)method,and P<0.05 indicated that the prognostic factors were statistically significant.Results: The analysis of clinical data showed that the 70 patients with multiple primary lung cancers in our hospital accounted for 3.3%(70/2115)of the patients diagnosed with lung cancer during the same period,and the median age was 59 years old.Females(72.9%)with a history of non-severe smoking(82.9%),no respiratory symptoms(64.3%),simultaneous multiple primary lung cancer(87.1%),and no adjuvant chemotherapy(75.7%)after surgery;pathological data analysis showed that70 MPLC patients in our hospital had the highest stage In stage IA(70.0%),the largest lesion with the largest diameter ≤ 3cm(72.9%);adenocarcinoma-adenocarcinoma(88.6%)is the majority;among the 149 MPLC cancer lesions,the right upper lung lobe is distributed(31.5%),lung adenocarcinoma The majority of the lesions(93.3%)were;among the 139 multiple primary lung adenocarcinoma lesions,acinar-type lung adenocarcinoma(39.6%)was the majority.The 3-year overall survival rate was 93.8%;the median follow-up time of 65 MPLC patients with accurate survival time was 53months;after Kaplan-Meier univariate analysis,the final prognostic factors are:whether there is a history of heavy smoking(P=0.011),whether there is postoperative adjuvant chemotherapy(P=0.001),whether the lesion is located on the same side of the lung(P=0.043),the largest lesion has the largest diameter(0.001),whether there is N1 lymph node metastasis(P=0.048),the highest TNM staging(P=0.000);patients with multiple primary lung cancers with a history of heavy smoking,lesions on the same side,largest lesions greater than 3 cm in diameter,N1 lymph node metastasis,and postoperative adjuvant chemotherapy have poor survival prognosis.The influencing factors that are not statistically significant are: gender(P=0.081),age(P=0.454),serum tumor markers(P=0.139),With or without other underlying diseases(P=0.777),surgical methods(P=0.152),simultaneous/different multiple primary lung cancers(P=0.439),total number of lesions(P=0.444),whether the lesion is located in the same lobe(P=0.241).COX proportional hazards regression model multivariate survival analysis did not find statistically significant prognostic factors.Conclusion: Among patients with multiple primary lung cancers,women,non-severe smoking history,no respiratory symptoms,simultaneous multiple primary lung cancers,lesions with a maximum diameter of ≤3 cm,the highest TNM stage as stage IA,and adenocarcinoma-adenocarcinoma patients Mostly;the 3-year overall survival rate is 93.8%,and the prognosis is good;multiple primary cases with a history of heavy smoking,lesions on the same side,largest lesions greater than 3 cm in diameter,N1 lymph node metastasis,postoperative adjuvant chemotherapy,and late staging The survival prognosis of patients with lung cancer is poor;there are still many difficulties and controversies in the diagnosis and staging of multiple primary lung cancers,which need to arouse more scholars’ attention and research.