â…¢A, â…¢B Non-small Cell Lung Cancer With Surgery Combined Therapy Effectiveness Analysis

Objectives To explore the survival data of surgery and related multiple modality treatment in stage ⅢA&IIIB non-small cell lung cancer (NSCLC), compare the IASLC proposed TNM descriptors and stage grouping revisions with UICC6staging system, and observe alterations of T cell subpopulations and NK cell of patients receiving surgery.Materials and methods Two hundred and twenty-four patients of stage ⅢA, ⅢB&IV NSCLC who underwent surgery and related multiple modality treatment during1997to2007in the Department of Thoracic Surgery of PUMC Hospital were reviewed. The comparisons were made between UICC6and IASLC TNM staging criteria with different T4and Ml descriptors. The T subpopulations and NK cells detected of33cases among stageⅢ NSCLC patients before surgery and1-month after surgery were compared.Results The overall1-year and3-year survival rate of stage Ⅲ NSCLC patients were90.8%and52.5%, and the median survival time was38.0months. The consistent rate of UICC6&IASLC TNM staging results was68.3%. There were no difference between "ipsilateral intra-pulmonary nodules" and "other T4descriptors" in1-year,3-year survival rate and median survival time, which were significant different when comparing the "malignant pleural/pericardial effusion" with above two subgroups, however. The survival data of T4N0-1MO patients were better than T4N2M0patients’, but the differences were not significant. In patients of stage III NSCLC, the CD3%、 CD4%and CD8%were significantly decreased, the NK cells were significantly increased. Comparing with the preoperational data, the CD8%of overall NSCLC patients were significantly increased, and the T cell subpopulations of adenocarcinoma patients were almost restored the normal level.Conclusion The IASLC has improved the differentiation of stageⅢ NSCLC, allowing better prognostication of these patients. The patients of stage ⅢA&ⅢB both could benefit from surgery and related multiple modality treatment. A statistically significant decrease T cell subpopulations indicated the suppression of the cellular immunity in the patients with stage III NSCLC before surgery. The surgery might improve the status of immunity of the patients.