Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore, Singapore.
Pulmonary Disease Program, Vanderbilt University Hospital, Nashville, Tennessee, USA.
Respiration. 2018;96(4):308-313. doi: 10.1159/000489315. Epub 2018 Jun 26.
Patients with malignant pleural effusion (MPE) secondary to lung cancer have been associated with poor prognosis historically. LENT score developed to risk-stratify unselected patients with MPE predicts prognosis of < 6 months in patients with lung cancer.
To assess the performance of LENT score in predicting prognosis in selected population of MPE secondary to lung adenocarcinoma alone.
A retrospective observational study was conducted by reviewing the medical records of patients managed for MPE in the year 2012.
Seventy patients with lung adenocarcinoma presenting with MPE were studied. The median (range) LENT score at initial diagnosis was 5 (2-7), and the median survival 7.9 (0.13-40) months. Thirty-nine patients received epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKIs). The median LENT score and median survival was 4 (2-7) and 14.4 months, respectively, in this group. Those in high-risk category by LENT in this group (n = 19) had a median survival and 6-month survival of 17.4 months and 73.6%, respectively. Thirty-one patients were treated with conventional chemotherapy. The median LENT score and median survival was 5 (2-7) and 4.1 (0.13-34.3) months, respectively, in this group. The median survival and 6-month survival rate in patients in high-risk category and moderate-risk category by LENT score was 6.2 months and 52.7%, and 11.4 months and 70.5%, respectively.
LENT score underestimates prognosis in patients having MPE secondary to lung adenocarcinoma. This disparity particularly applies to the lung adenocarcinoma patients carrying EGFR mutation. Hence, LENT score may not be applicable to, or may need modification before applying to such patients.
历史上，患有肺癌相关恶性胸腔积液（MPE）的患者预后较差。LENT 评分用于对 MPE 患者进行风险分层，预测肺癌患者 6 个月内的预后。
评估 LENT 评分在预测单纯肺腺癌所致 MPE 患者预后中的表现。
通过回顾 2012 年 MPE 患者的病历，进行回顾性观察性研究。
共研究了 70 例患有肺腺癌合并 MPE 的患者。初次诊断时的中位（范围）LENT 评分为 5（2-7），中位生存期为 7.9（0.13-40）个月。39 例患者接受了表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）治疗。该组的中位 LENT 评分和中位生存期分别为 4（2-7）和 14.4 个月。该组中 LENT 高危患者（n=19）的中位生存期和 6 个月生存率分别为 17.4 个月和 73.6%。31 例患者接受常规化疗。该组的中位 LENT 评分和中位生存期分别为 5（2-7）和 4.1（0.13-34.3）个月。LENT 评分高危和中危患者的中位生存期和 6 个月生存率分别为 6.2 个月和 52.7%，11.4 个月和 70.5%。
LENT 评分低估了患有肺腺癌相关 MPE 的患者的预后。这种差异尤其适用于携带 EGFR 突变的肺腺癌患者。因此，LENT 评分可能不适用于此类患者，或者在应用于此类患者之前需要进行修改。
