罹患2型糖尿病对非小细胞肺癌脑转移患者预后的影响  

The impact of type 2 diabetes mellitus on prognosis of non-small cell lung cancer with brain metastases

作　　者：王利利[1] 刘群[1] 尹强[1] 孙增峰[1] 佘春华[1] 李文良[1] Wang Lili Liu Qun Yin Qiang Sun Zengfeng She Chunhua Li Wenliang(Department of Oncology, Tianfin Medical University Cancer Institute ＆ Hospital, National Clinical Research Center for Cancer, Tianjin 300060, Chin)

机构地区：[1]天津医科大学肿瘤医院脑系肿瘤科,国家肿瘤临床研究中心,天津市肿瘤防治重点实验室,天津性恶性肿瘤临床医学研究中心,300060

出　　处：《中华神经外科杂志》2017年第3期265-269,共5页Chinese Journal of Neurosurgery

摘　　要：目的探讨罹患2型糖尿病对非小细胞肺癌脑转移患者预后的影响。方法回顾性分析2010年10月至2015年5月天津医科大学肿瘤医院脑系肿瘤科、放疗科、肺部肿瘤内科、肺部肿瘤科收治的406例非小细胞肺癌脑转移患者的临床资料。利用Log—rank检验和Cox回归分析，寻找影响非小细胞肺癌脑转移患者预后的因素，以及罹患糖尿病对患者总生存期（OS）和无进展生存期（PFS）的影响。结果单因素分析结果表明，年龄、淋巴结分期、糖尿病病史、接受一线或二线化疗方案治疗、Karnofsky功能状态评分可影响患者的0s（均P〈0．05）；淋巴结分期、糖尿病病史、接受一线或二线化疗方案治疗可对患者的PFS产生影响（均P〈0．05）。多因素分析结果表明，糖尿病病史（OR：0．203，95％CI：0．067～0．618，P=0．005）、淋巴结分期（OR：0．573，95％CI：0．420—0．781，P〈0．001）以及年龄（OR：0．609，95％CI：0．409—0．907，P=0．015）为非小细胞肺癌脑转移患者0s的独立影响因素；糖尿病病史（OR：0．317，95％CI：0．112～0．900，P=0．031）、淋巴结分期（OR：0．723，95％c，：0．556—0．941，P=0．016）、是否接受化疗（OR：0．450，95％C1：0．253—0．798，P：0．006）为非小细胞肺癌脑转移患者PFS的独立影响因素。结论罹患糖尿病可能能够延长非小细胞肺癌脑转移患者的OS和PFS。Objective To investigate the impact of type 2 diabetes mellitus （DM） on prognosis of non-small cell lung cancer with brain metastases. Methods We retrospectively reviewed the clinical data of 406 patients, who were diagnosed as non-small cell lung cancer with brain metastases and admitted to the departments of brain tumor, radiation therapy, pulmonary medicine and pulmonary surgery at Tianjin University Cancer Institute ＆ Hospital from October 2010 to May 2015. Log-rank analysis and Cox regression model were used to identify prognostic factors of non-small cell lung cancer with brain metastases and the impact of type 2 DM on the overall survival （OS） and progression-free survival （PFS）. Results Univariate analysis of OS revealed that age, lymph node staging, DM, chemotherapy, Karnofsky performance score had statistical significance （all P 〈 0.05 ）. Univariate analysis of PFS revealed that lymph node staging, DM, chemotherapy had statistical significance （ all P 〈 0.05 ）. Multivariate analysis showed that presence of DM （OR, 0.203, 95% CI0.067-0.618, P=0.005）, lymph node staging （OR, 0.573, 95% CI 0. 420- 0.781, P〈0. 001） and age （OR, 0. 609, 95% CI O. 409 -0. 907, P =0. 015） were considered independent prognostic factors for OS （P 〈 0.05）. In addition, DM （ OR, 0.317, 95% CI 0.112 - 0. 900, P =0. 031 ） , lymph node staging （ OR, 0. 723, 95% CI O. 556 - 0. 941, P = 0. 016） and chemotherapy （ OR, 0. 450, 95% CI O. 253 - 0.798, P = 0. 006） were identified as independent prognostic factors for PFS （P 〈 0.05）. Conclusion It is suggested that a history of type 2 DM might be correlated with increased OS and PFS in patients with NSCLC with brain metastases.

关 键 词：癌 非小细胞肺 糖尿病 2型 预后 脑转移 

分 类 号：R734.2[医药卫生—肿瘤]