68例原发灶不明癌的预后因素分析  

Analysis of prognostic factors in 68 patients with cancer of unknown primary site

作　　者：寇小格[1] 梁东良[1] 张清琴[1] 李小瑞[1] 赵艳争[1] 谷见法[1] 路平[1] 

机构地区：[1]新乡医学院第一附属医院肿瘤科,河南省卫辉市453100

出　　处：《中华肿瘤杂志》2011年第10期783-786,共4页Chinese Journal of Oncology

摘　　要：目的探讨原发灶不明癌的临床特点及预后影响因素。方法收集68例原发灶不明癌（腺癌46例，鳞癌22例）患者的临床和随访资料，对其临床特征、肿瘤标志物、血常规、肝功能等与生存时间的关系进行单因素及多因素分析。结果68例原发灶不明癌患者中位生存时间为123d，1年生存率为16．6％。单因素分析表明，患者PS评分、是否肝转移、转移灶数口、癌胚抗原、乳酸脱氢酶、血清白蛋白、血红蛋白及淋巴细胞计数与原发灶不明癌患者的预后有关（均P〈0．01）。Cox因素回归分析结果显示，患者PS评分≥2分、有肝转移、癌胚抗原高于正常值、乳酸脱氢酶高于正常值、血清白蛋白〈35g/L和淋巴细胞计数≤0．7×10^9／L是原发灶不明癌患者的独立不良预后因素。按具备不良预后因素的数目，将患者分为3个亚组，即0～1个不良预后因素组、2～3个不良预后因素组及4～6个不良预后因素组，各组的中位生存时间分别为390、138和77d。0～1个不良预后因素组的生存率与其他两组比较，差异均有统计学意义（均P〈0．05），2—3个不良预后因素组与4～6个不良预后因素组生存率比较，差异无统计学意义（P〉0．05）。结论患者PS评分／〉2分、有肝转移、癌胚抗原升高、乳酸脱氢酶升高、血清白蛋白降低和淋巴细胞计数减少是原发灶不明癌患者的独立不良预后因素，同时具备两个以上不良预后因素的患者预后较差。Objective The aim of this study was to analyze the clinical characteristics and prognostic factors in patients with cancer of unknown primary site （CUP）. Methods The clinical and follow-up data of 68 CUP patients （46 adenocarcinoma patients, 22 squamous cell carcinoma patients ）, were retrospectively analyzed. Univariate and multivariate analysis were conducted to determine the correlation of survival with clinical features , tumor markers , blood test , liver function and so on. Results The median survival time of the 68 CUP patients was 123 days. The results from univariate Cox regression analysis showed that the prognostic factors were related to a performance status, presence or absence of liver metastases, the number of metastatic sites, carcinoembryonic antigen （CEA）, lactate dehydrogeriase （LDH）, hypoalbuminemia, hypohemoglobinemia and lymphocyte count. Multivariate Cox regression analysis of the clinical factors identified that a performance status （PS） ≥ 2 , liver metastasis, elevated serum carcinoembryonic antigen （CEA） and lactate dehydrogenase （LDH） levels, hypoalbuminemia （ 〈 35 g/L） and lymphopenia （ ≤0.7 ×10^9/L） were significant independent unfavorable predictive factors. Based on the number of the unfavorable predictive factors, we divided all the patients into three subgroups： subgroup involving 0-1 unfavorable factor, subgroup involving 2-3 unfavorable factors and subgroup involvfilg 4-6 unfavorable factors. The median survival time was 390 days, 138 days and 77 days, respectively, in the 3 subgroups. Compared with the other two groups, the survival of the subgroup involving 0-1 unfavorable factor was significantly longer （ P 〈 0.05 ） , the survival betweenthe subgroup involving 2-3 unfavorable factors and subgroup involving 4-6 unfavorable factors was not significantly different （P 〉 0.05 ）. Conclusions A performance status ≥ 2, liver metastasis, elevated serum carcinoembryonic antigen and lactate dehydrogenase levels, hypoalbuminemia

关 键 词：原发灶不明癌 临床特征 预后 COX回归分析 

分 类 号：R730.5[医药卫生—肿瘤]