Iachina Maria, Jakobsen Erik, Møller Henrik, Lüchtenborg Margreet, Mellemgaard Anders, Krasnik Mark, Green Anders
Center for Clinical Epidemiology, Odense University Hospital, Sdr. Boulevard 29, Entrance 101, 4rd Floor, 5000, Odense C, Denmark,
Lung. 2015 Apr;193(2):291-7. doi: 10.1007/s00408-014-9675-5. Epub 2014 Dec 17.
Primary lung cancer is one of the most common types of cancers. Comorbidity has been shown to be a negative prognostic factor in the overall lung cancer population. The significance of the individual comorbidities is less well known. The purpose of this paper is to investigate the effect of each comorbid disease groups on survival.
The analysis is based on all patients with NSCLC who were registered in 2009-2011, in total 10,378 patients. To estimate the effect of each comorbidity group on the survival, we fitted a Cox regression model for each comorbidity group adjusting for age, sex, resection, and stage.
Patients with cardiovascular comorbidity have a 30% higher death rate [HR 1.30 with 95% CI (1.13; 1.49)] than patients without comorbidity. Patients with diabetes and patients with cerebrovascular disorders and COPD have a 20% excess mortality than patients without comorbidity: [HR 1.19 with CI (1.02; 1.39) for diabetes, HR 1.18 with CI (1.05; 1.33) for cerebrovascular disorders, and HR 1.20 with CI (1.10; 1.39 for COPD)].
Our study shows the importance of cardiovascular disease in lung cancer. Diabetes, cerebrovascular disorders, and COPD also have a significant impact on survival of NSCLC patients.
原发性肺癌是最常见的癌症类型之一。合并症已被证明是整个肺癌患者群体中的一个负面预后因素。但个体合并症的意义尚不十分清楚。本文的目的是研究各合并症组对生存率的影响。
分析基于2009 - 2011年登记的所有非小细胞肺癌患者，共10378例。为了评估每个合并症组对生存率的影响，我们针对每个合并症组拟合了一个Cox回归模型，对年龄、性别、手术切除和分期进行了调整。
有心血管合并症的患者死亡率比无合并症的患者高30%[风险比1.30，95%置信区间(1.13; 1.49)]。糖尿病患者、脑血管疾病患者和慢性阻塞性肺疾病患者的死亡率比无合并症的患者高20%：[糖尿病患者风险比1.19，置信区间(1.02; 1.39)；脑血管疾病患者风险比1.18，置信区间(1.05; 1.33)；慢性阻塞性肺疾病患者风险比1.20，置信区间(1.10; 1.39)]。
我们的研究表明心血管疾病在肺癌中的重要性。糖尿病、脑血管疾病和慢性阻塞性肺疾病对非小细胞肺癌患者的生存率也有显著影响。
