ABSTRACT
Objective To compare the clinical features and prognosis in patients with accidental N1 phase and expected N1 phase of non-small cell lung cancer( NSCLC) . Methods Retrospective analysis was performed on the one hundred and seventy-six NSCLC patients who underwent surgery and were pathologically diagnosed with pT1-3N1M0 phase NSCLC from January 2008 to June 2012. Among them,there were 75 patients with accidental N1 disease (cN0-pN1) NSCLC (accidental group),and 101 patients with expected N1 disease (cN1-pN1) NSCLC (clinical group). The clinical features,metastasis and recurrence,survival time,1,3,5-year survival rates of the two groups were analyzed. Results There were significant differences in tumor diameter, pathologic T staging,the number of lymph node metastasis and the number of stations between the two groups (P<0. 05) . The local recurrence rate of the patients in the accident group was 10. 7% ( 8/ 75), which was significantly lower than that in the clinical group 21. 8% ( 22/ 101), and the difference was statistically significant (χ2 = 7. 988,P= 0. 039). The survival time of accidental group was (46. 8±5. 5) months,compared with the expected group ((29. 7±4. 9) months),it was obviously prolonged (t = 8. 665,P = 0. 029). The 1,3 and 5 year survival rates in the accident group were 85. 3% (64/ 75),57. 3% (43/ 75),42. 7% (32/ 75), respectively,which were significantly higher than those in the clinical group (73. 3% (74/ 101),43. 6% (44/101),28. 7% (29/ 101)) (χ2 = 6. 089,7. 490,9. 112,P<0. 05). Conclusion The clinical manifestations are different. N1 phase NSCLC patients have a certain degree of heterogeneity. Accidental N1 phase NSCLC patients have obvious advantages in local recurrence and long-term survival than those with clinical N1 phase NSCLC.
ABSTRACT
Objective To investigate the influence of brain natrluretic peptide(BNP) in the prognosis of cardiac surgery.Methods Selected 115 cases of pafients with the first cardiac surgery.Their BNP concentration was measured before operation. Observed the relationship between BNP and postoperative atrial fibrillation,mechanical ventilation time,hospital stay,and the mortality of 30 d.Results Whether the patients had hypertension,diabetes,myocardial infarction history,left main stem disease and hemoglobin level or not,showed no definite relationship with BNP (P>0.05).Preoperative lower left ventricular ejection fraction (LVEF)(P=0.002) and European system for cardiac operation risk evaluation [(5±3)scores](P=0.003) were associated with higher BNP level.Postoperative mechanical ventilation time was(15.0±5.4)h,hospital stay was (32±11) d,showed a clear relationship with BNP(P= 0.035,0.001),but postoperative mediastinal infection,atrial fibrillation and mortality of 30 d had no definite relationship with BNP(P>0.05).Conclusion BNP can be used to predict the risk after cardiac surgery.