基于SEER数据库分析脏层胸膜侵犯在Ⅰ_(B)期非小细胞肺癌患者中的预后价值  

Analysis of prognostic value of visceral pleural invasion in patients with stageⅠB non-small-cell lung cancer based on SEER database

作　　者：李丽[1] 郭孟刚[2] 罗晓斌[1] Li Li;Guo Menggang;Luo Xiaobin(Department of Respiratory and Critical Medicine,Suining Central Hospital,Suining,Sichuan 629000,China;Department of Thoracic Surgery,Suining Central Hospital,Suining,Sichuan 629000,China)

机构地区：[1]遂宁市中心医院呼吸与危重症医学科,四川遂宁629000 [2]遂宁市中心医院胸外科,四川遂宁629000

出　　处：《现代临床医学》2022年第4期245-248,260,共5页Journal of Modern Clinical Medicine

基　　金：四川省卫生和计划生育委员会科研课题(18PJ409)。

摘　　要：目的:分析脏层胸膜侵犯(VPI)在Ⅰ_(B)期非小细胞肺癌(NSCLC)患者中的预后价值,探讨其他影响预后的因素。方法:从监测、流行病学和最终结果(SEER)数据库中收集2010—2015年VPI状态明确并行手术治疗的Ⅰ_(B)期NSCLC患者资料。采用倾向评分匹配法(PSM)获得基线资料均衡的无VPI组和VPI组病例,Kaplan-Meier法绘制生存曲线并使用Log-rank法比较差异,Cox比例风险模型分析影响患者肺癌特异性生存时间(LCSS)的独立危险因素。结果:共纳入5885例患者(无VPI组3437例,VPI组2448例),PSM后两组病例各935例。VPI组比无VPI组的LCSS差(HR=1.378,95%CI:1.108~1.713,P=0.004);年龄较大、男性、病理分级较高、肿瘤较大及行亚肺叶切除的患者是LCSS的独立危险因素。结论:VPI是提示Ⅰ_(B)期NSCLC患者预后不良的因素,并且无论有无VPI,年龄较大、男性、病理分级较高、肿瘤较大及行亚肺叶切除的患者LCSS较差。Objective:To analyze the prognostic value of visceral pleural invasion(VPI)in the patients with stageⅠB nonsmall-cell lung cancer(NSCLC),and to explore other factors affecting the prognosis.Methods:The data of stageⅠB NSCLC patients with definite VPI status who received surgery from 2010 to 2015 were collected from the surveillance,epidemiology,and end results(SEER)database.Propensity score matching(PSM)was performed to obtain balanced baseline data between the non-VPI group and the VPI group.Survival curves were drawn by the Kaplan-Meier method and compared by the Log-rank test.Cox proportional hazards model was used to identify the independent risk factors for lung cancer specific survival(LCSS)in patients.Results:A total of 5885 patients were included,including 3437 patients in non-VPI group and 2448 patients in VPI group.After PSM,935 patients in each group were obtained with balanced baseline data.The LCSS in VPI group was worse than that in non-VPI group(HR=1.378,95%CI:1.108-1.713,P=0.004).Older age,male,higher pathological grade,larger tumor size and sublobectomy were independent risk factors for LCSS.Conclusion:VPI is a poor prognostic factor in patients with stageⅠB NSCLC.Regardless of VPI status,LCSS is worse in patients with male gender,older age,higher pathological grade,and undergoing sublobectomy.

关 键 词：非小细胞肺癌 脏层胸膜侵犯 SEER 倾向评分匹配 预后 

分 类 号：R730[医药卫生—肿瘤]