精准治疗时代肺-分子GPA评分对晚期非小细胞肺癌脑转移预后分析的意义  

Significance of Lung-molecular GPA Score in Prognosis Analysis of Advanced Non-small Cell Lung Cancer with Brain Metastasis in Precise Treatment Era

作　　者：张香花[1] 李子立[1] 左学荣[1] 崔洪霞[1] 马丽霞[1] ZHANG Xiang-hua;LI Zi-li;ZUO Xue-rong;CUI Hong-xia;MA Li-xia(Department of Thoracic Oncology Internal Medicine,Jilin Cancer Hospital,Changchun 130000,China)

机构地区：[1]吉林省肿瘤医院胸部肿瘤内科,吉林长春130000

出　　处：《中国医药指南》2020年第11期156-157,共2页Guide of China Medicine

摘　　要：目的肺癌脑转移是最常见的颅内转移性肿瘤,预后差,生存期短。表皮生长因子受体(epidermal growth factor receptor,EGFR)突变和间变性淋巴瘤激酶(anaplastic lymphoma kinase,ALK)融合突变的肺癌易出现脑转移,靶向治疗的出现很好的控制脑转移。本研究探讨影响非细胞肺癌(non-small cell lung cancer,NSCLC)脑转移患者预后的相关因素,对比分析新的预测模型肺-分子GPA(预后评估评分,graded prognostic assessment,GPA)及GPA模型在肺癌脑转移中的应用,利用有效预测模型评价脑转移瘤患者的预后,为NSCLC脑转移预后评估及治疗提供依据。方法选择2012年1月至2014年1月笔者所在医院收治的初治的NSCLC伴有脑转移患者80例,进行回顾性研究。应用SPSS19.0软件行Kaplan Meier法进行生存率分析,Log-rank检验进行单因素分析,多因素分析采用Cox回归模型。结果单因素分析显示患者的KPS评分(karnofsky performance scale,KPS)、脑转移灶数目、有无颅外转移、基因突变及不同治疗模式是非小细胞肺癌脑转移瘤患者的预后因素(P<0.05)。多因素分析显示KPS评分、有无颅外转移、EGFR及ALK基因突变与肺癌脑转移预后相关(P<0.05)。结论肺-分子GPA模型对NSCLC伴有基因突变脑转移预后有更好的预测作用。肺-GPA作为一个新的预后模型是有用的肺癌脑转移预测模型。Objective Brain metastasis of lung cancer is the most common intracranial metastatic tumor with poor prognosis and short survival.Lung cancer with the epidermal growth factor receptor(EGFR)mutation and anaplastic lymphoma kinase(ALK)fusion mutation are prone to brain metastasis.The emergence of targeted therapy is a good control of br ain metastasis.This study investigated the factors infl uencing the prognosis of patients with nonsmall cell lung cancer(NSCLC)with brain metastasis.Comparative analysis of new prediction model of lung-molecular GPA(prognosis assessment score,graded prognostic assessment,GPA)and GPA model in the application of brain metastases from lung cancer,An effective predictive model was used to evaluate the prognosis of patients with brain metastases,providing a basis for the prognosis evaluation and treatment of NSCLC brain metastases.Methods We were selected and retrospectively studied of 80 patients with newly diagnosed non-small cell lung cancer(NSCLC)with brain metastases in our hospital from January 2012 to January 2014 with brain metastasis.The survival rate was analyzed by Kaplan Meier method Log-rank test was used for Single factor analysis.Cox regression model was used for multivariate analysis.Statistical signifi cance was defi ned as P<0.05,with SPSS19.0 software.Results Single factor analysis showed KPS score(karnofsky performance scale),the number of brain metastases,presence or absence of extracranial metastases,EGFR and ALK gene mutations,and Different treatment modes were associated with the prognosis of lung cancer with brain metastasis(P<0.05).Multivariate analysis showed that KPS score,extracranial metastasis,EGFR and ALK gene mutations were associated with the prognosis of lung cancer with brain metastasis(P<0.05).Conclusion The lung-molecular GPA model has a better predictive effect on the prognosis of NSCLC with gene mutation of brain metastasis.As a new prognostic model,lung-molecular GPA is a useful prediction model for lung cancer brain metastasis.

关 键 词：非小细胞肺癌 脑转移 肺-分子 GPA EGFR ALK 预后因素 

分 类 号：R734.2[医药卫生—肿瘤]