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[不可切除肺癌的预后因素]

[Prognostic factors in unresectable lung cancer].

作者信息

Urata A

机构信息

Dept. of Respiration and Circulation, Aishi Cancer Center Hospital.

出版信息

Gan To Kagaku Ryoho. 1988 Jul;15(7):2035-42.

PMID:2840034
Abstract

Seventy-seven prognostic factors influencing survival time in patients with unresectable lung cancer treated from 1964 to 1983 at Aichi Cancer Center Hospital were analyzed using univariate analysis by log rank test and multivariate analysis by proportional hazard model of Cox. Statistical significance using univariate analysis was identified in 19 factors in small cell lung cancer patients, and in 40 factors in non-small cell lung cancer patients. The string prognostic factors determined by multivariate analysis were, in the order of importance, serum LDH level, chest pain, peripheral lymphocyte count, bone marrow metastasis, brain metastasis, age, and performance status in small cell lung cancer patients. These 7 factors had a p value of less than 0.01. On the other hand, they were the number of metastatic sites, performance status, serum albumin level, serum LDH level, sex, BUN level, N category according to TNM staging system in non-small cell lung cancer patients, with a p value of less than 0.001. The most important prognostic factors were serum LDH level in small cell lung cancer, and the number of metastatic sites and performance status in non-small cell lung cancer. A metastasis to bone marrow or brain was a more important prognostic factor than overall M category in small cell lung cancer patients, and the number of metastatic sites rather than clinical stage classification or TNM staging system in non-small cell lung cancer patients with respect to staging system. Accurate evaluation of the treatment results in unresectable lung cancer patients must take the strong prognostic factors into account.

摘要

对1964年至1983年在爱知癌症中心医院接受治疗的无法切除肺癌患者的77个影响生存时间的预后因素,采用对数秩检验进行单因素分析,并通过Cox比例风险模型进行多因素分析。单因素分析显示,小细胞肺癌患者中有19个因素具有统计学意义,非小细胞肺癌患者中有40个因素具有统计学意义。多因素分析确定的重要预后因素,按重要程度排序,小细胞肺癌患者依次为血清乳酸脱氢酶(LDH)水平、胸痛、外周淋巴细胞计数、骨髓转移、脑转移、年龄和体能状态。这7个因素的p值小于0.01。另一方面,非小细胞肺癌患者的预后因素为转移部位数量、体能状态、血清白蛋白水平、血清LDH水平、性别、尿素氮(BUN)水平、根据TNM分期系统的N分类,p值小于0.001。最重要的预后因素,小细胞肺癌为血清LDH水平,非小细胞肺癌为转移部位数量和体能状态。在小细胞肺癌患者中,骨髓或脑转移比总体M分类是更重要的预后因素;在非小细胞肺癌患者的分期系统方面,转移部位数量比临床分期分类或TNM分期系统更重要。对无法切除肺癌患者的治疗结果进行准确评估时,必须考虑这些重要的预后因素。

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