Ⅲ期小细胞肺癌年轻患者的肿瘤特异性生存优势  

Tumor-specific survival advantage in young patients with stage Ⅲ small cell lung cancer

作　　者：焦清华 周庆博[1] 王燕[1] 徐敏[1] 陈慧玲 文洁[1] JIAO Qinghua;ZHOU Qingbo;WANG Yan;XU Min;CHEN Huiling;WEN Jie(Geriatric Medicine Department,The Southern Hospital Area of Second Hospital of Shandong University,Jinan 250000,Shandong,China)

机构地区：[1]山东大学第二医院南部院区老年医学科

出　　处：《山东大学学报（医学版）》2019年第12期68-73,共6页Journal of Shandong University:Health Sciences

基　　金：国家重点研发计划(2018YFC0114704)

摘　　要：目的考察年龄对小细胞肺癌(SCLC)患者预后评估的价值。方法登陆监测、流行病学及最终结果(SEER)登记系统,查询2010年1月至2013年12月的所有SCLC病例(n=17 237)。青年组定义为年龄≤49岁的患者(n=733),中年组定义为50~64岁的患者(n=6 332),老年组定义为年龄≥65岁的患者(n=10 172)。分析各组患者的临床病理特征,获取肿瘤特异性生存(CSS)等数据,应用Kaplan-Meier法及多变量Cox回归模型进行统计分析。结果单因素及多因素分析均显示,随着年龄的增加,CSS缩短(χ^2=342.08,P<0.001),其中青年组患者的OS(χ^2=203.90,P<0.001)和CSS(χ^2=160.50,P<0.001)均提高。中年组风险比(HR)为1.177(95%CI:1.068~1.296,P=0.001),老年组HR为1.643(95%CI:1.495~1.807,P<0.001)。在Ⅰ期(P=0.015)、Ⅲ期(P<0.001)、Ⅳ期(P<0.001)或接受非手术治疗(P<0.001)的患者中,年龄越小,CSS越具优势。结论年龄≤49岁的SCLC患者较更年长患者具有生存优势;在Ⅲ期及接受非手术治疗的患者中,年龄具有较明确的预后价值。Objective To estimate the prognostic value of age on small cell lung cancer(SCLC) patients. Methods The Surveillance, Epidemiology, and End Results(SEER) population-based data was queried for SCLC patients from Jan. 2010 to Dec. 2013, and 17 237 cases were enrolled. The cases ≤ 49 years were defined as young group(n=733), 50-64 years were defined as middle-aged group(n=6 332), and the cases ≥ 65 years were defined as elderly group(n=10 172). Clinicopathological characteristics of patients were analyzed. Cancer-specific survival(CSS) data were obtained. The analysis of CSS outcomes and risk factors were analyzed by Kaplan-Meier methods and multivariable Cox regression model. Results Both univariate and multivariate analyses showed that CSS significantly decreased with advanced ages(χ^2=342.08, P<0.001). The OS(χ^2=203.9, P<0.001) and CSS(χ^2=160.5, P<0.001) of the young group were improved. In middle-aged group, hazard ratio(HR) was 1.177(95%CI: 1.068-1.296, P=0.001);in elderly group, HR was 1.643(95%CI: 1.495-1.807, P<0.001). Smaller age guaranteed a significantly improved CSS in patients who were at stages Ⅰ(P=0.015), Ⅲ(P<0.001), Ⅳ(P<0.001) or underwent non-surgical treatment(P<0.001). Conclusion Compared to older patients, the SCLC patients ≤49 years hold advantages in both OS and CSS. The prognostic value of age is more exact in patients at stage Ⅲ or managed non-operatively.

关 键 词：小细胞肺癌 年轻 肿瘤特异性生存 监测、流行病学及最终结果登记系统 

分 类 号：R575.3[医药卫生—消化系统]