Department of General Thoracic Surgery, Tottori University Hospital, Yonago, Tottori, Japan.
Respirology. 2010 Apr;15(3):495-500. doi: 10.1111/j.1440-1843.2010.01708.x. Epub 2010 Feb 24.
The Japanese Respiratory Society recently proposed 'lung age' as an easily understood concept of respiratory function. In this study, we evaluated whether 'lung age' could be a useful predictor of post-operative respiratory complications and survival patients with lung cancer treated surgically.
The study recruited 308 patients who underwent surgery for primary non-small-cell lung cancer. All patients had preoperative pulmonary function testing. 'Lung age' was determined using the methods advocated by the Japanese Respiratory Society. Based on the difference between 'real age' (R) and 'lung age' (L), patients were classified into five groups: group A: R-L > 15 (n = 37), B: 5 < R-L <or= 15 (n = 50), C: -5 <or= R-L <or= 5 (n = 73), D: -15 <or= R-L < -5 (n = 54), E: -15 > R-L (n = 94). Clinicopathological factors, post-operative respiratory complications and survival were compared between the groups.
Gender, smoking status and index, histology, operative approach and FEV(1) were significantly associated with the group classification. The incidence of complications was significantly higher in group E compared with other groups (P = 0.003). Multivariate analysis showed that the group classification by 'lung age' was an independent predictor of post-operative respiratory complications (P = 0.02). Overall survival differed significantly between the groups (P = 0.03).
'Lung age' could be useful for the prediction of post-operative respiratory complications and survival in patients with lung cancer treated surgically.
日本呼吸学会最近提出了“肺龄”的概念,作为一种易于理解的呼吸功能概念。本研究旨在评估“肺龄”是否可作为预测接受手术治疗的肺癌患者术后呼吸并发症和生存的有用指标。
该研究纳入了 308 例接受原发性非小细胞肺癌手术治疗的患者。所有患者均接受了术前肺功能检查。采用日本呼吸学会推荐的方法确定“肺龄”。根据“实际年龄”(R)与“肺龄”(L)的差值,将患者分为 5 组:A 组:R-L>15(n=37);B 组:5<R-L≤15(n=50);C 组:-5≤R-L≤5(n=73);D 组:-15≤R-L<-5(n=54);E 组:R-L<-15(n=94)。比较各组间的临床病理因素、术后呼吸并发症和生存情况。
性别、吸烟状态和指数、组织学类型、手术入路和 FEV1 与分组显著相关。E 组的并发症发生率明显高于其他组(P=0.003)。多因素分析显示,“肺龄”分组是术后呼吸并发症的独立预测因素(P=0.02)。各组间总生存情况差异有统计学意义(P=0.03)。
“肺龄”可用于预测接受手术治疗的肺癌患者术后呼吸并发症和生存情况。