初诊时空腹血糖浓度对肺癌患者预后的评估价值  

Prognostic value of fasting glucose concentration in patients with newly diagnosed lung cancer

作　　者：王维雯 代思思 李镭[1] 李为民[1] WANG Weiwen;DAI Sisi;LI Lei;LI Weimin(Department of Respiratory and Critical Care Medicine,West China Hospital / West China School of Medicine,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川大学华西医院呼吸与危重症医学科/华西临床医学院,成都610041

出　　处：《华西医学》2019年第4期375-378,共4页West China Medical Journal

基　　金：国家自然科学基金(91859203;81871890);四川省国际科技创新合作/港澳台科技创新合作项目(2018HH0161)

摘　　要：目的探究初诊时空腹血糖浓度在预测肺癌预后中的作用。方法回顾性分析2008年1月—2011年12月于四川大学华西医院初次确诊的956例肺癌患者临床资料,并对患者进行5年以上的随访。以空腹血糖浓度6.1 mmol/L作为截断值,将患者划分为高血糖组和对照组,采用Kaplan-Meier法进行生存分析,并用对数秩检验分析不同组的生存差异,通过Cox比例风险回归模型进行单因素及多因素分析。结果高血糖组患者166例,5年生存率为23.5%,对照组患者790例,5年生存率为30.8%,差异有统计学意义(P=0.008)。单因素Cox比例风险回归分析发现血糖浓度、性别、年龄、吸烟史、分期以及是否进行手术治疗均为影响患者5年生存率的因素(P<0.05);多因素Cox比例风险回归分析显示血糖浓度[风险比(hazard ratio,HR)=1.235,95%置信区间(confidence interval,CI)(1.013,1.504),P=0.036]、年龄[HR=1.305,95%CI(1.110,1.534),P=0.001]、吸烟史[HR=1.210,95%CI(1.033,1.418),P=0.018]、分期[HR=1.546,95%CI(1.172,2.040),P=0.002]以及是否进行手术治疗[HR=0.330,95%CI(0.257,0.424),P<0.001]均为影响5年生存率的独立因素,其中血糖浓度、年龄、吸烟史以及分期为独立危险因素。结论初诊时空腹血糖浓度可作为预测肺癌患者预后的指标。Objective To explore the prognostic value of fasting blood glucose concentration in patients with newly diagnosed lung cancer.Methods The clinical data of 956 patients with lung cancer who were first diagnosed at West China Hospital of Sichuan University between January 2008 and December 2011 were retrospectively analyzed.The patients were followed up for more than 5 years.Using the fasting blood glucose concentration of 6.1 mmol/L as the cutoff value,the patients were divided into the hyperglycemia group and the control group.Kaplan-Meier method was used for survival analysis,and log-rank test was used to analyze the survival of different groups.Univariate and multivariate Cox proportional hazard models were used to evaluate the prognostic variables.Results There were 166 patients in the hyperglycemia group with a 5-year overall survival rate of 23.5%,and 790 patients in the control group with a 5-year survival rate of 30.8%,and the difference between the two groups was statistically significant(P=0.008).Univariate Cox proportional hazard analysis found that blood glucose concentration,gender,age,smoking history,staging,and whether surgery were factors that affected the 5-year survival rate of patients(P<0.05);multivariate Cox proportional hazard analysis showed that blood glucose concentration[hazard ratio(HR)=1.235,95%confidence interval(CI)(1.013,1.504),P=0.036],age[HR=1.305,95%CI(1.110,1.534),P=0.001],smoking history[HR=1.210,95%CI(1.033,1.418),P=0.018],staging[HR=1.546,95%CI(1.172,2.040),P=0.002],and whether surgical treatment[HR=0.330,95%CI(0.257,0.424),P<0.001]were independent factors which influenced 5-year survival rate.Blood glucose concentration,age,smoking history,and staging were independent risk factors.Conclusion Fasting blood glucose concentration is able to be a prognostic factor for patients with newly diagnosed lung cancer.

关 键 词：肺癌 空腹血糖 预后 

分 类 号：R734.2[医药卫生—肿瘤]