Background and objective: The new edition of the TNM staging for lung and pleural tumours has been finished, which put weight on the extent of primary tumor as one of the important prognosises. But little study has performed on the primary tumor extent < or = 2 cm. The aim of this study is to explore the prognosis of patients with tumor extent < or = 2 cm in stage I of non-small cell lung cancer, which helps us to choose the best treatment for these patients.
Methods: Retrospective study on the clinical response and survival time of whom underwent complete surgical resection and diagnosed as T1a of stage I NSCLC from 1998 to 2004 was analyzed. Data was analyzed by SPSS 17.0 software.
Results: Overall survival rate was 80.8%. By the study, age (P = 0.241), gender (P = 0.175), history of smoking (P = 0.845), pathologic type ( P =0.265), and systematic mediastinal lymphadenectomy (SML )(P = 0.918) or not, postoperative adjuvant chemotherapy or not ( P = 0.616) and visceral pleural invasion (P = 0.827) were not the prognosises of these patients. Only the tumor differentiation such as poorly differentiated was the important prognosis ( P = 0.01).
Conclusion: In the tumor extent < or = 2 cm of stage I non-small cell lung cancer, the visceral pleural invasion maybe not influence the patients survival. The tumor differentiation is one of the important prognostic factors.
背景与目的: 新的第7版非小细胞肺癌（non-small cell Lung cancer, NSCLC）分期已经提出肿瘤直径对NSCLC预后的重要性，但是对癌灶直径≤2 cm预后研究尚少。本研究旨在探讨影响癌灶≤2 cm（T1a）的Ⅰ期NSCLC病人的临床预后因素，为临床预后治疗提供依据。
方法: 回顾性分析本院既往手术后病理诊断为癌灶≤2 cm（T1a）的Ⅰ期的73例NSCLC病人，运用统计学软件SPSS 17.0分析影响长期生存的临床因素。
结果: 该类患者5年以上总体生存率达到80.8%。性别（P=0.175）、年龄（P=0.241）、病理类型（P=0.265）、是否行系统纵隔淋巴结清扫手术（P=0.918）、是否术后辅助化疗（P=0.616）、是否侵犯胸膜（P=0.827）和该类患者的长期生存无明显相关性。影响预后的主要因素是癌灶的分化程度，即在中度分化程度以下长期生存较差（P=0.01）。
结论: 在癌症直径≤2 cm的Ⅰ期肺癌中，侵犯胸膜对生存无影响，而分化程度是一个重要的独立预后因素。