肺腺鳞癌患者的转移模式与预后：一项基于监测、流行病学及最终结果的人群研究。
Metastatic pattern and prognosis in patients with lung adenosquamous carcinoma: A surveillance, epidemiology, and end results-based population study.
作者信息
Xie Jun, Li Chong
机构信息
Department of Respiration, First People's Hospital of Changzhou, Third Affiliated Hospital of Soochow University, Juqian Road No.185, Changzhou, China.
出版信息
Heliyon. 2024 May 6;10(9):e30641. doi: 10.1016/j.heliyon.2024.e30641. eCollection 2024 May 15.
BACKGROUND
Lung adenosquamous carcinoma (ASC) is a rare tumor with high invasive and metastatic potential. Few studies have explored metastatic patterns in patients with advanced-stage ASC.
METHODS
Patients diagnosed with ASC in the Surveillance, Epidemiology, and End Results database from 2010 to 2015 were selected. Descriptive statistics were obtained to characterize the metastatic sites of the study participants. The Kaplan-Meier method was applied to compare survival curves among patients with different metastatic patterns. Cox regression analysis was performed to evaluate risk factors for metastasis.
RESULTS
A total of 858 eligible patients with ASC were enrolled; the mean age was 71.5 years (standard deviation ± 7.8 years). There was a slightly higher proportion of male patients (54.0 %). A total of 63.2 % of patients harbored single-site metastasis (median OS: 5 months), 23.6 % of patients had two-site metastasis (median OS: 4 months), and approximately 10 % of patients harbored three or more sites metastasis (median OS: 3 months). Bone (56.9 %) was the most frequent site of metastasis (median OS: 4 months), followed by lung metastasis (37.6 %, median OS: 5 months), liver metastasis (22.1 %, median OS: 5 months), and brain metastasis (21.4 %, median OS: 4 months). Chemotherapy decreased the risk of death by 70 % (HR = 0.296, 95 % CI 0.241-0.363), 70 % (HR = 0.302, 95 % CI 0.224-0.406), 78 % (HR = 0.218, 95 % CI 0.151-0.314), and 70 % (HR = 0.302, 95 % CI 0.231-0.396) in patients harboring bone, liver, brain and lung metastases, respectively. The brain increased the risk of death by 50 % (HR = 1.501, 95 % CI 1.209-1.865), 64 % (HR = 1.644, 95 % CI 1.126-2.402), and 128 % (HR = 2.284, 95 % CI 1.653-3.157) in patients harboring bone, liver and lung metastases, respectively.
CONCLUSION
Patients with advanced-stage ASC have unfavorable outcomes. Early detection and aggressive treatment can improve patients outcomes.
背景
肺腺鳞癌（ASC）是一种罕见肿瘤，具有高侵袭性和转移潜能。很少有研究探讨晚期ASC患者的转移模式。
方法
选取2010年至2015年监测、流行病学和最终结果数据库中诊断为ASC的患者。获得描述性统计数据以表征研究参与者的转移部位。应用Kaplan-Meier方法比较不同转移模式患者的生存曲线。进行Cox回归分析以评估转移的危险因素。
结果
共纳入858例符合条件的ASC患者；平均年龄为71.5岁（标准差±7.8岁）。男性患者比例略高（54.0%）。共有63.2%的患者发生单部位转移（中位总生存期：5个月），23.6%的患者发生双部位转移（中位总生存期：4个月），约10%的患者发生三个或更多部位转移（中位总生存期：3个月）。骨转移（56.9%）是最常见的转移部位（中位总生存期：4个月），其次是肺转移（37.6%，中位总生存期：5个月）、肝转移（22.1%，中位总生存期：5个月）和脑转移（21.4%，中位总生存期：4个月）。化疗使骨转移、肝转移、脑转移和肺转移患者的死亡风险分别降低70%（风险比[HR]=0.296，95%置信区间[CI]0.241-0.363）、70%（HR=0.302，95%CI0.224-0.406）、78%（HR=0.218，95%CI0.151-0.314）和70%（HR=0.302，95%CI0.231-0.396）。脑转移分别使骨转移、肝转移和肺转移患者的死亡风险增加50%（HR=1.501，95%CI1.209-1.865）、64%（HR=1.644，95%CI1.126-2.402）和128%（HR=2.284，95%CI1.653-3.157）。
结论
晚期ASC患者预后不佳。早期检测和积极治疗可改善患者预后。
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