Maeda T, Ueoka H, Tabata M, Kiura K, Shibayama T, Gemba K, Takigawa N, Hiraki A, Katayama H, Harada M
Department of Internal Medicine II, Okayama University Medical School, Japan.
Jpn J Clin Oncol. 2000 Dec;30(12):534-41. doi: 10.1093/jjco/hyd139.
Non-small cell lung cancer (NSCLC) is resistant to chemotherapy and prognosis of advanced NSCLC patients is considered to be dependent on various prognostic factors.
We analyzed prognostic factors in patients with advanced NSCLC who had been enrolled in clinical trials conducted by the Okayama Lung Cancer Study Group between 1978 and 1992 using two kinds of multivariate analysis, Cox's multivariate analysis and recursive partitioning and amalgamation (RPA) analysis.
The first analysis was performed on 261 patients using 28 variables. Performance status (PS), clinical stage, liver metastasis or serum albumin level was an independent prognostic factor by Cox's analysis. In the second analysis performed on 128 patients having data on neuron specific enolase (NSE), NSE was the most important prognostic factor. Using the RPA method, three subgroups with significantly different survival potentials were defined. Among them, patients with normal serum NSE levels and good PS were found to obtain a markedly favorable prognosis [median survival time (MST) 22.1 months, 3-year survival rate 42.9%], whereas the survival of patients with elevated serum NSE levels and bone metastasis was extremely short (MST 4.7 months, 3-year survival rate 0%).
These results indicate that analysis of prognostic factors including serum levels of NSE is useful for predicting the survival of patients with advanced NSCLC.
非小细胞肺癌（NSCLC）对化疗具有抗性，晚期NSCLC患者的预后被认为取决于多种预后因素。
我们使用两种多变量分析方法，即Cox多变量分析和递归划分与合并（RPA）分析，对1978年至1992年间参加冈山肺癌研究组开展的临床试验的晚期NSCLC患者的预后因素进行了分析。
首次分析使用28个变量对261例患者进行。通过Cox分析，体能状态（PS）、临床分期、肝转移或血清白蛋白水平是独立的预后因素。在对128例有神经元特异性烯醇化酶（NSE）数据的患者进行的第二次分析中，NSE是最重要的预后因素。使用RPA方法，定义了三个具有显著不同生存潜力的亚组。其中，血清NSE水平正常且PS良好的患者预后明显较好[中位生存时间（MST）22.1个月，3年生存率42.9%]，而血清NSE水平升高且有骨转移的患者生存期极短（MST 4.7个月，3年生存率0%）。
这些结果表明，分析包括血清NSE水平在内的预后因素有助于预测晚期NSCLC患者的生存情况。
