467例小细胞肺癌患者的预后分析  

Prognostic Factors for the Survival of 467 Patients with Small Cell Lung Cancer

作　　者：吴超[1] 焦顺昌[1] 

机构地区：[1]解放军总医院肿瘤内科,北京市100853

出　　处：《中国肿瘤临床》2011年第10期568-571,共4页Chinese Journal of Clinical Oncology

摘　　要：目的:肺癌发病率逐年上升,死亡率居癌症之首,其中小细胞肺癌恶性程度最高。本研究旨在分析小细胞肺癌的独立预后因素。方法:回顾性分析解放军总医院2005年1月至2009年12月经组织病理或细胞学确诊的467例小细胞肺癌患者,对可能影响其预后的相关因素进行单因素和多因素分析。结果:局限期患者1、2、3年生存率分别为81.72%、54.95%、41.09%,中位生存时间为27个月。广泛期患者1、2、3年生存率分别为66.81%、25.77%、17.06%,中位生存时间为17个月。单因素分析显示年龄、临床分期、是否肝转移、是否手术、化疗、放疗、一线化疗疗效、一线化疗周期数、初治时血红蛋白水平、LDH值、NSE值及CY-FRA21-1值与患者预后相关(P<0.05)。多因素分析显示是否放疗、总周期数、一线化疗疗效和CYFRA21-1对患者的生存时间有显著影响。结论:是否放疗、化疗总周期数、一线化疗疗效和初治时CYFRA21-1水平是影响小细胞肺癌的独立预后因素。Objective： To analyze the prognostic factors of patients with small cell lung cancer （ SCLC ）. Methods： Clinical data were collected from 467 patients with small cell lung cancer （ SCLC ） who were diagnosed through histopathology or cytology. We analyzed whether some factors influenced survival time. Kaplan-Meier, COX multivariate proportional hazards model, and Log-rank test were used to analyze the prognostic factors. Results： The 12-month, 24-month, and 36-month survival rates were 75.94%, 44.76%, and 32.05%, respectively. The rates were 81.72%; 54.95%; and 41.09% in limited disease （ LD ） patients and 66.81%; 25.77%; and 17.06% in extensive disease （ ED ） patients. The median survival time （ MST ） of all the patients was 22 months, 27 months in LD, and 17 months in ED. Univariate analyses indicated that age, stage, liver metastasis, operation, chemotherapy, radiotherapy, efficacy of first-line chemotherapy, the cycle number of first-line chemotherapy, and the levels of hemoglobin （Hb）, lactate dehydrogenase （ LDH ）, CYFRA 21-1, and neuron-specific enolase （ NSE ） significantly influenced survival of SCLC. The multivariate analyses suggest that radiotherapy, the total number of cycles of chemotherapy, the efficacy of first-line chemotherapy, and CYFRA 21-1 level are independent prognostic factors of survival, Conclusion： The use of radiotherapy, the total number of cycles of chemotherapy, the efficacy of first-line chemotherapy, and the level of the CYFRA 21-1 are important prognostic factors for patients with SCLC.

关 键 词：小细胞肺癌 化疗 放疗 手术 预后 

分 类 号：R734.2[医药卫生—肿瘤]