吸烟对非小细胞肺癌患者死亡率的影响。
Impact of smoking on mortality of patients with non-small cell lung cancer.
机构信息
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine Seoul, Korea; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Gyeongsang National University Hospital Jinju, Korea.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine Seoul, Korea.
出版信息
Thorac Cancer. 2014 Jan;5(1):43-9. doi: 10.1111/1759-7714.12051. Epub 2014 Jan 2.
BACKGROUND
Cigarette smoking is one of the major causes of lung cancer. However, the correlation between smoking status and the survival of patients with lung cancer is uncertain. The present study aimed to evaluate the impact of smoking status on the mortality of patients with non-small cell lung cancer (NSCLC).
METHODS
The medical records of 313 patients newly diagnosed with NSCLC between January 2005 and January 2006 were reviewed. Eligible patients were divided into ever-smokers (221 patients) and never-smokers (92 patients), and the overall survival and clinical characteristics of the two groups were compared. Predictors of survival were analyzed using Cox's proportional hazards regression.
RESULTS
In ever-smokers, the mean age was higher, and male gender and squamous histology were predominant compared to never-smokers. The median survival time was longer in never-smokers (21.1 vs. 41.9 months, ever-smokers vs. never-smokers, respectively; P = 0.027). Overall survival estimates at 12, 24, and 60 months were 62.9 versus 82.6%, 43.4 versus 65.2%, and 31.2 versus 42.4%, in each group. Advanced age, advanced disease stage (stages III and IV), and coexistence of interstitial lung disease were analyzed as independent risk factors for shorter survival. Although ever-smoking was not an independent risk factor, current smoking was a risk factor for higher mortality.
CONCLUSIONS
The overall mortality of ever-smokers was higher than that of never-smokers in patients with newly diagnosed NSCLC, and current smoking was an independent risk factor for a poorer prognosis.
背景
吸烟是肺癌的主要原因之一。然而，吸烟状况与肺癌患者的生存之间的相关性尚不确定。本研究旨在评估吸烟状况对非小细胞肺癌（NSCLC）患者死亡率的影响。
方法
回顾了 2005 年 1 月至 2006 年 1 月期间新诊断为 NSCLC 的 313 名患者的病历。合格的患者被分为吸烟者（221 名）和不吸烟者（92 名），比较两组的总体生存率和临床特征。使用 Cox 比例风险回归分析生存的预测因素。
结果
在吸烟者中，平均年龄较高，男性和鳞状组织学更为常见。与不吸烟者相比，从不吸烟者的中位生存时间更长（21.1 对 41.9 个月；P=0.027）。12、24 和 60 个月的总生存率估计值分别为 62.9%对 82.6%、43.4%对 65.2%和 31.2%对 42.4%。高龄、晚期疾病分期（III 和 IV 期）和间质性肺疾病共存被分析为生存时间较短的独立危险因素。虽然吸烟状况不是独立的危险因素，但目前吸烟是更高死亡率的危险因素。
结论
与新诊断为 NSCLC 的不吸烟者相比，吸烟者的总体死亡率更高，目前吸烟是预后较差的独立危险因素。
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