Cancer Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xicheng District, Beijing, 100050, China.
State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology, Taipa, Macau, 999078, China.
BMC Pulm Med. 2017 Aug 15;17(1):112. doi: 10.1186/s12890-017-0452-0.
This retrospective study investigated the association between the Charlson comorbidity index (CCI) score and the survival of patients with stage IIIB-IV (advanced, non-resectable) non-small cell lung cancer (NSCLC) who also did not have gene mutations in epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK).
The records of 165 patients (28-80 y, median 61 y) who met the above criteria and were admitted to Beijing Friendship Hospital Capital Medical University from 1 May 2010 to 1 October 2014were reviewed. Associations between baseline variables and the CCI score were assessed via univariate and multivariate logistic regression analysis. Overall survival was defined as the time from the first clinic visit to death from any cause, or to the end of follow-up. Survival curves were estimated via the Kaplan-Meier method and compared with the log-rank test.
Logistic regression analyses indicated that smoking and performance status were independently associated with the CCI score. Smoking was associated with an increased risk of mortality (odds ratio (OR) 4.12 (95% confidence interval [CI] 1.92-8.84) compared to non-smokers), as was performance status 2 (ambulatory, capable of self-care, unable to perform any work activities; active for >50% of waking hours) (OR 2.22 (95% CI, 1.14-4.33) compared to performance status 1). Univariate Cox's regression analyses showed that the hazard ratios were significantly associated with the CCI score (P = 0.009), smoking (P = 0.042), and male gender (P = 0.021).
The CCI score is an important prognostic factor for the prediction of overall survival in patients with stage IIIB-IV NSCLC who are negative for EGFR and ALK gene mutations.
本回顾性研究旨在探讨 Charlson 合并症指数（CCI）评分与表皮生长因子受体（EGFR）或间变性淋巴瘤激酶（ALK）基因无突变的 IIIB-IV 期（晚期、不可切除）非小细胞肺癌（NSCLC）患者生存的关系。
回顾性分析 2010 年 5 月 1 日至 2014 年 10 月 1 日期间首都医科大学北京友谊医院收治的 165 例符合上述标准的患者（年龄 28-80 岁，中位年龄 61 岁）的病历资料。采用单因素和多因素 logistic 回归分析评估基线变量与 CCI 评分的关系。总生存期定义为从首次就诊至任何原因死亡或随访结束的时间。采用 Kaplan-Meier 法估计生存曲线，并采用对数秩检验进行比较。
logistic 回归分析表明，吸烟和体力状态与 CCI 评分独立相关。与不吸烟者相比，吸烟者的死亡风险增加（优势比（OR）4.12（95%置信区间[CI]1.92-8.84）），体力状态 2 级（能走动，自理能力，无法从事任何工作活动；清醒时活动>50%）（OR 2.22（95%CI，1.14-4.33））与体力状态 1 级相比）。单因素 Cox 回归分析显示，危险比与 CCI 评分（P=0.009）、吸烟（P=0.042）和男性性别（P=0.021）显著相关。
CCI 评分是预测 EGFR 和 ALK 基因阴性的 IIIB-IV 期 NSCLC 患者总生存期的重要预后因素。
