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吸烟量对非小细胞肺癌临床病理特征和生存的影响。

Impact of smoking amount on clinicopathological features and survival in non-small cell lung cancer.

机构信息

Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

Department of Applied Statistics, Yonsei University, Seoul, Republic of Korea.

出版信息

BMC Cancer. 2020 Sep 3;20(1):848. doi: 10.1186/s12885-020-07358-3.

Abstract

BACKGROUND

Screening for early detection of lung cancer has been performed in high-risk individuals with smoking history. However, researches on the distribution, clinical characteristics, and prognosis of these high-risk individuals in an actual cohort are lacking. Thus, the objective of this study was to retrospectively review characteristics and prognosis of patients with smoking history in an actual lung cancer cohort.

METHODS

The present study used the lung cancer cohort of the Catholic Medical Centers at the Catholic University of Korea from 2014 to 2017. Patients with non-small cell lung cancer were enrolled. They were categorized into high and low-risk groups based on their smoking history using the national lung screening trial guideline. Distribution, clinical characteristics, and survival data of each group were estimated.

RESULTS

Of 439 patients, 223 (50.8%) patients were in the high-risk group. Patients in the high-risk group had unfavorable clinical characteristics and tumor biologic features. Overall survival of the high-risk group was significantly shorter than that of the low-risk group with both early (I, II) and advanced stages (III, IV). In multivariate analysis, heavy smoking remained one of the most important poor clinical prognostic factors in patients with lung cancer. It showed a dose-dependent relationship with patients' survival.

CONCLUSIONS

High-risk individuals had poor clinical outcomes. Patients' prognosis seemed to be deteriorated as smoking amount increased. Therefore, active screening and clinical attention are needed for high-risk individuals.

摘要

背景

有吸烟史的高危人群已经进行了肺癌早期检测筛查。然而,对于实际队列中这些高危人群的分布、临床特征和预后的研究还很缺乏。因此,本研究旨在回顾性分析实际肺癌队列中具有吸烟史患者的特征和预后。

方法

本研究使用了韩国天主教大学天主教医疗中心的肺癌队列,时间范围为 2014 年至 2017 年。纳入了非小细胞肺癌患者。根据国家肺癌筛查试验指南,根据吸烟史将他们分为高危组和低危组。估计了每组的分布、临床特征和生存数据。

结果

在 439 名患者中,223 名(50.8%)患者属于高危组。高危组患者具有不利的临床特征和肿瘤生物学特征。高危组的总生存率明显低于早期(I、II 期)和晚期(III、IV 期)的低危组。多变量分析显示,重度吸烟仍然是肺癌患者最重要的不良临床预后因素之一。它与患者的生存呈剂量依赖性关系。

结论

高危人群的临床结局较差。随着吸烟量的增加,患者的预后似乎恶化。因此,需要对高危人群进行积极的筛查和临床关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3f93/7469911/8e4538816525/12885_2020_7358_Fig1_HTML.jpg

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