血清乳酸脱氢酶对老年晚期非小细胞肺癌患者化疗的预后判断价值  

Prognostic Value of Serum Lactic Dehydrogenase for Elderly Patients with Adva Nced Non-small Cell Lung Cancerreceiving Chemotherapy

作　　者：王椿[1] 张明峰[1] 周麟[1] 邓浩[1] 安振梅[1] 李双庆[1] 丁振宇[1] 

机构地区：[1]四川大学华西医院内分泌代谢科全科医学科胸部肿瘤科,四川成都610041

出　　处：《四川医学》2015年第10期1374-1378,共5页Sichuan Medical Journal

基　　金：国家自然科学基金资助项目(编号:81272684;81200640)

摘　　要：目的 本研究旨在探讨血清乳酸脱氢酶（ LDH）在老年晚期非小细胞肺癌（ NSCLC）患者化疗中潜在的预后判断价值. 方法 回顾性分析2007年1月到2009年3月经组织学或细胞学证实的老年（≥70岁） NSCLC患者,收集患者化疗前血清LDH水平,观察并记录近期疗效及远期生存情况,对LDH正常和LDH升高的两组患者临床资料及生存时间进行比较并进行相关性分析. 结果 共纳入71例老年NSCLC患者,其中LDH正常组44例,LDH升高组27例. 两组患者的年龄、性别、体力状态、分期（ IIIB或IV期）、病理构成及吸烟状态,差异均无统计学意义（ P〈0. 05 ）. LDH正常组有更多的患者具有合并症（P=0. 009）. 两组患者的客观缓解率（P=0. 582）、疾病控制率（P=0. 679）及疾病进展时间差异无统计学意义（P=0. 656）. 但两组患者总生存时间有明显差异,LDH正常组生存时间更长,差异有统计学意义趋势（P=0. 05）. 经过COX多因素分析,排除年龄、性别、分期、病理类型、体力状态、吸烟状态、及有无合并症等因素后,发现血清LDH可能是独立预后因素（P=0. 024,死亡风险比HR=0. 473,95%CI：0. 248~0. 905）. 结论 血清LDH对老年晚期NSCLC患者化疗的预后判断可能具有潜在价值.Objective This study is to investigate the potential prognostic value of serum lactate dehydrogenase（ LDH） in the elderly patients with advanced NSCLC. Methods This study retrospectively enrolled elderly patients（≥ 70 years） with ad-vanced NSCLC from January 2007 to March 2009. The short-term efficacy and survival time of the NSCLC patients were observed. The serum LDH values before chemotherapy were recorded. Results Totally 71 patients including 44 cases with normal LDH （ normal LDH group） and 27 cases with elevated LDH（ increased LDH group） were enrolled in the study. The demographic features were similar between the two groups except less patients with co-morbidity in the increased LDH group（P=0. 009）. There were no significant difference in response rate（P=0. 582）, disease control rate（P=0. 679）and time-to-progression（P=0. 656）. The patients in the normal LDH group tended to live longer than those in the increased LDH group （P=0. 05）. Excluding the factor of age, sex, stage, pathologic type, performance status, smoking status, and the presence of co-morbidities, LDH might be an inde-pendent prognostic factor（P=0. 024, hazard ratio：0. 473, 95% CI：0. 248~0. 905）in the advanced NSCLC. Conclusion The basal serum LDH level might be an independent prognostic factor in the elderly patients with advanced NSCLC who were receiving chemotherapy.

关 键 词：非小细胞肺癌 乳酸脱氢酶 老年 化疗 预后 

分 类 号：R734.2[医药卫生—肿瘤]