90例青年肺癌患者的临床特征及预后分析  

Analysis on clinical characteristics and prognosis in 90 young patients with lung cancer

作　　者：岳渝 肖何[1] 金丰[1] 陈川[1] 杨雪琴[1] 单锦露[1] 仲召阳[1] 杨镇洲[1] 谢家印[1] 王阁[1] 王东[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所肿瘤中心,重庆400042

出　　处：《重庆医学》2015年第13期1762-1764,共3页Chongqing medicine

摘　　要：目的 探讨青年肺癌的临床病理特征、治疗效果和预后影响因素,为青年肺癌的个体化分层提供依据。方法 回顾性分析该院90例40岁及以下的肺癌患者的临床资料,分别对临床特征、治疗方法及手术后患者无病生存期（DFS）,未手术患者一线治疗效果及无进展生存期（PFS）、总生存时间（OS）等进行评估。结果 90例患者中位年龄38岁,男女比例1.25∶1,以腺癌为主（占71.1%）,临床分期以晚期为主,Ⅲa~Ⅳ期占65.6%。整体人群PFS 9.6个月（6.76~12.44）、总体中位OS 48.5个月（18.51~78.49）。其中手术患者的中位随访时间24个月,总体中位DFS为11.8个月（8.5~15.1）,总体中位OS为52.0个月（33.9~70.2）。T、N、M和临床分期是独立预后因素。非手术患者32例,总体中位随访时间8个月,总体中位PFS为7.0个月（4.2~9.9）,总体中位OS为25.7个月（16.0~35.4）。非手术患者中培美曲塞二钠＋铂类（PP）方案显著降低进展风险,相反,腺癌相对于其他组织学类型进展风险显著增高。对OS的多变量分析表明,化疗周期数是唯一的独立预后因素,患者死亡风险随着化疗周期数增多而显著下降。结论 青年肺癌以腺癌为主,首选手术治疗,晚期不能手术者首选PP方案。Objective To investigate the clinicopatbological features, curative effects and prognostic influencing factors of young lung cancer to provide the basis for individualization stratification. Methods The clinical data in 90 cases of lung cancer aged 40 and below in our hospital were respectively analyzed for assessing the clinical features,treatment methods and postoperative dis- easeffree survival （DFS）,first-line treatment effects of non-surgical patients and progression-free survival （PFS）, overall survival （OS）,etc. Results In 90 cases of lung cancer,median age was 38 years, the ratio of male to female was 1.25： 1;the majority of pathological type was adenocarcinoma, accounting for 71.1% ;the clinical stage was dominated by the late stage ,Ⅲ a-Ⅳ accounting for 65.60%. The whole crowd PFS was 9.6 months （6.76- 12.44 months）, the overall median OS was 48.5 months （18. 51- 78.49 months）. Among them, the median follow-up time in surgical patients was 24 months, the overall median DFS was 11. 8 months （8.5-15.1 months） ,the overall median OS was 52.0 months （33.9-70.2 months）. T,N,M and clinical stages were the independent prognostic factors. Among 32 cases of non-surgery, the overall median follow-up time was 8 months, the overall median PFS was 7.0 months （4.2-9.9 months） ,the overall median OS was 25.7 months （16.0-35.4 months）. In non-surgical patients, the PP scheme significantly reduced the risk of progression,on the contrary,adenocarcinoma significantly increased the risk of progression compared with other histological types. The OS multivariate analysis showed that the number of chemotherapy cycles was the only independent prognostic factor,the risk of death was significantly decreased with the increase o{ the chemotherapy cycles number. Conclusion The majority of pathological type is adenocarcinoma in younger patients with lung cancer and the surgical treatment is the first choice. The pemetrexed disodium scheme is the first choice for the patients with inoperable

关 键 词：肺肿瘤 临床特征 预后 青年 

分 类 号：R734.2[医药卫生—肿瘤]