Ogino Hirokazu, Hanibuchi Masaki, Kakiuchi Soji, Saijo Atsuro, Tezuka Toshifumi, Toyoda Yuko, Tobiume Makoto, Otsuka Kenji, Sakaguchi Satoshi, Goto Hisatsugu, Arisawa Kokichi, Nishioka Yasuhiko
Department of Respiratory Medicine and Rheumatology, Graduate School of Biomedical Sciences, Tokushima University.
J Med Invest. 2016;63(3-4):286-93. doi: 10.2152/jmi.63.286.
Small-cell lung cancer (SCLC) presents aggressive clinical behavior, and its prognosis is still poor. Previously, performance status (PS), or the existence of brain, bone, or liver metastasis were reported to be unfavorable prognostic factors. Given the recent progress of treatment modalities such as radiotherapy techniques and bone modifying agents, the prognostic factors might be different from previous findings. Therefore, we analyzed the prognostic factors of extensive disease SCLC (ED-SCLC) in recent years.
ED-SCLC patients treated in Tokushima University Hospital between 2010 and 2016 were analyzed. Log-rank test and the Cox proportional hazards regression model was used in univariate and multivariate analysis, respectively.
Totally, 79 patients were analyzed. In the univariate analysis, age, PS, interstitial pneumonia (IP), liver metastasis, pleural dissemination, neutrophil counts, hypoalbuminemia, hypercalcemia and several liver and biliary enzymes were identified as poor prognostic factors. In the multivariate analysis, age, PS, IP, and liver and biliary enzymes were identified. Moreover, the PS in patients with liver metastasis was significantly worsened.
In this study, we newly demonstrated that IP was a significant poor prognostic factor of ED-SCLC. Although liver metastasis was not extracted in multivariate analysis, it may have an impact on the prognosis of ED-SCLC. J. Med. Invest. 63: 286-293, August, 2016.
小细胞肺癌（SCLC）具有侵袭性临床行为，其预后仍然很差。此前，据报道，体能状态（PS）或存在脑、骨或肝转移是不良预后因素。鉴于放疗技术和骨改良剂等治疗方式的最新进展，预后因素可能与先前的研究结果不同。因此，我们分析了近年来广泛期小细胞肺癌（ED-SCLC）的预后因素。
分析了2010年至2016年在德岛大学医院接受治疗的ED-SCLC患者。分别采用对数秩检验和Cox比例风险回归模型进行单因素和多因素分析。
共分析了79例患者。在单因素分析中，年龄、PS、间质性肺炎（IP）、肝转移、胸膜播散、中性粒细胞计数、低白蛋白血症、高钙血症以及几种肝和胆汁酶被确定为不良预后因素。在多因素分析中，确定了年龄、PS、IP以及肝和胆汁酶。此外，肝转移患者的PS显著恶化。
在本研究中，我们首次证明IP是ED-SCLC的一个显著不良预后因素。尽管在多因素分析中未提取到肝转移，但它可能对ED-SCLC的预后有影响。《医学调查杂志》63: 286 - 293，2016年8月。
