第IA期肺腺癌病患術後復發之預後因子

10.6666/ClinMed.201805_81(5).0048

洪榮志

肺腺癌(lung adenocarcinoma) ； 組織學(histology) ； 預後(prognosis) ； 復發(recurrence) ； 存活率(survival)

臨床醫學月刊

81卷5期（2018 / 05 / 25）

270 - 273

繁體中文

肺癌是全世界癌症死亡的主要原因。近來由於胸部電腦斷層掃描篩檢的增加，肺腺癌似乎有越來越多的趨勢。第IA期肺腺癌是相當早期的肺腺癌，手術切除的治療效果很好。但是即使是第IA期或小於三公分淋巴結陰性的肺癌，腫瘤復發仍是手術切除後治療失敗的主要原因。肺腺癌新的組織學分類法具有顯著的預後價值，微乳頭型和實體型病患具有較差的預後。肺腺癌組織學新分類法亦與病患之縱膈腔淋巴結轉移具有顯著的相關性。針對第IA期或小於三公分淋巴結陰性的肺癌，除了性別與腫瘤大小之外，肺腺癌組織學亞型也是這些病患無復發存活串的顯著預後因子。是否針對微乳頭/實體型為主的第IA期肺腺癌病患給予輔助治療，是未來臨床試驗研究的方向，並將有助於進一步提升肺腺癌病患之治療成果。

1. Dai, C,Xie, H,Kadeer, X(2017).Relationship of Lymph Node Micrometastasis and Micropapillary Component and Their Joint Influence on Prognosis of Patients With Stage I Lung Adenocarcinoma.Am J Surg Pathol,41,1212-1220.
2. Hung, JJ(2017).Histologic subtype component predicts lymph node micrometastasis and prognosis in patients with stage I lung adenocarcinoma.J Thorac Dis,9,3623-3625.
3. Hung, JJ,Jeng, WJ,Chou, TY(2013).Prognostic value of the New International Association for the Study of Lung Cancer/American Thoracic Society/ European Respiratory Society Lung Adenocarcinoma Classification on Death and Recurrence in Completely Resected Stage I Lung Adenocarcinoma.Ann Surg,258,1079-1086.
4. Hung, JJ,Yeh, YC,Jeng, WJ(2014).Predictive Value of the International Association for the Study of Lung Cancer/American Thoracic Society/ European Respiratory Society Classification of Lung Adenocarcinoma in Tumor Recurrence and Patient Survival.J Clin Oncol,32,2357-2364.
5. Hung, JJ,Yeh, YC,Jeng, WJ(2016).Factors predicting occult lymph node metastasis in completely resected lung adenocarcinoma of 3cm or smaller.Eur J Cardiothorac Surg,50,329-336.
6. Hung, JJ,Yeh, YC,Wu, YC(2017).Prognostic Factors in Completely Resected Node-negative Lung Adenocarcinoma of 3cm or Smaller.J Thorac Oncol,12,1824-1833.
7. Koga, K,Hamasaki, M,Kato, F(2013).Association of c-Met phosphorylation with micropapillary pattern and small cluster invasion in pT1-size lung adenocarcinoma.Lung Cancer,82,413-419.
8. Sasada, S,Nakayama, H,Miyata, Y(2015).Comparison of malignant grade between pure and partially invasive types of early lung adenocarcinoma.Ann Thorac Surg,99,956-960.
9. Sumiyoshi, S,Yoshizawa, A,Sonobe, M(2013).Pulmonary adenocarcinomas with micropapillary component significantly correlate with recurrence, but can be well controlled with EGFR tyrosine kinase inhibitors in the early stages.Lung Cancer,81,53-59.
10. Takenaka, T,Yamazaki, K,Miura, N(2016).The Prognostic Impact of Tumor Volume in Patients with Clinical Stage IA Non-Small Cell Lung Cancer.J Thorac Oncol,11,1074-1080.
11. Travis, WD,Brambilla, E,Noguchi, M(2011).International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society international multidisciplinary classification of lung adenocarcinoma.J Thorac Oncol,6,244-285.
12. Von der Thusen, JH,Tham, YS,Pattenden, H(2013).Prognostic significance of predominant histologic pattern and nuclear grade in resected adenocarcinoma of the lung: potential parameters for a grading system.J Thorac Oncol,8,37-44.
13. Warth, A,Muley, T,Meister, M(2012).The Novel Histologic International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society Classification System of Lung Adenocarcinoma Is a Stage-Independent Predictor of Survival.J Clin Oncol,30,1438-1446.
14. Xu, L,Tavora, F,Burke, A(2013).Histologic features associated with metastatic potential in invasive adenocarcinomas of the lung.Am J Surg Path,37,1100-1108.
15. Yeh, YC,Kadota, K,Nitadori, JI(2016).International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society classification predicts occult lymph node metastasis in clinically mediastinal node-negative lung adenocarcinoma.Eur J Cardiothorac Surg,49,e9-e15.
16. Yoshiya, T,Mimae, T,Tsutani, Y(2016).Prognostic Role of Subtype Classification in Small-Sized Pathologic N0 Invasive Lung Adenocarcinoma.Ann Thorac Surg,102,1668-1673.
17. Yoshizawa, A,Motoi, N,Riely, GJ(2011).Impact of proposed IASLC/ATS/ERS classification of lung adenocarcinoma: Prognostic subgroups and implications for further revision of staging based on analysis of 514 stage I cases.Mod Pathol,24,653-664.
18. Zhang, J,Wu, J,Tan, Q(2013).Why do pathological stage IA lung adenocarcinomas vary from prognosis? A clinicopathologic study of 176 patients with pathological stage IA lung adenocarcinoma based on the IASLC/ ATS/ERS classification.J Thorac Oncol,8,1196-1202.
19. Zhang, Y,Sun, Y,Shen, L(2013).Predictive Factors of Lymph Node Status in Small Peripheral Non-small Cell Lung Cancers: Tumor Histology is More Reliable.Ann Surg Oncol,20,1949-1954.
20. Zhong, C,Fang, W,Mao, T(2012).Comparison of thoracoscopic segmentectomy and thoracoscopic lobectomy for small-sized stage IA lung cancer.Ann Thorac Surg,94,362-367.

1. 葉惠玲,楊曜蓮,陳素華(2023)。一位初次罹患肺腺癌行楔形肺葉切除之手術全期護理。領導護理，24(1)，66-80。