慢性阻塞性肺疾病对晚期非小细胞肺癌患者预后的影响  

Effect of chronic obstructive pulmonary disease on prognosis of patients with advanced non-small cell lung cancer

作　　者：郝云霞[1] 李鹏龙[1] 辛林泽 许耀[2] HAO Yun-xia;Li Peng-long;XIN Lin-ze(Department of Internal Medicine Oncology,Laiyang Central Hospital,Yantai 265200,China)

机构地区：[1]烟台市莱阳中心医院肿瘤内科,265200 [2]烟台市莱阳中心医院心血管内科,265200

出　　处：《中国实用医药》2023年第1期1-5,共5页China Practical Medicine

基　　金：烟台市重点研发计划政策引导类(项目编号:2021YD093)项目名称:心肺功能状态对非小细胞肺癌(NSCLC)患者预后的影响。

摘　　要：目的 探讨慢性阻塞性肺疾病(COPD)对晚期非小细胞肺癌(NSCLC)患者预后的影响。方法 98例晚期NSCLC患者,根据肺功能结果分为COPD组(41例)和非COPD组(57例),比较两组的临床资料。采用Kaplan-Meier法绘制患者的生存曲线,比较不同因素影响下晚期NSCLC患者的生存预后;采用Cox回归分析探讨影响晚期NSCLC患者生存预后的危险因素。结果 COPD组男性、吸烟占比及N末端脑钠肽前体(NT-proBNP)水平分别为75.61%、63.41%、(754.34±357.07)ng/L,高于非COPD组的54.39%、28.07%、(615.26±306.21)ng/L,差异具有统计学意义(P<0.05);两组年龄、体质量指数(BMI)、病理类型、临床分期、胸腔积液、放疗、靶向治疗、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)和细胞角蛋白19可溶性片段(Cyfra21-1)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇、甘油三酯、空腹血糖、血肌酐、血尿酸、收缩压比较,差异无统计学意义(P>0.05)。98例晚期NSCLC患者随访期间有7例存活, 5年生存率为7.14%(7/98)。其中COPD组存活2例, 5年生存率为4.88%(2/41);非COPD组存活5例, 5年生存率为8.77%(5/57)。两组5年生存率比较差异无统计学意义(P>0.05)。Kaplan-Meier生存曲线分析结果显示:国际肺癌研究协会(IASLC)分期Ⅳ期、男性、合并COPD以及NT-proBNP>606.0 ng/L患者的生存时间短于IASLC分期Ⅲ期、女性、不合并COPD及NT-proBNP≤606.0 ng/L患者,差异具有统计学意义(P<0.05)。多因素Cox回归分析结果显示,男性、腺癌、临床分期Ⅳ期以及合并COPD是影响晚期NSCLC患者生存预后的独立危险因素(P<0.05)。结论 男性晚期NSCLC患者预后更差,合并COPD是影响晚期NSCLC患者生存预后的独立危险因素。Objective To discuss the effect of chronic obstructive pulmonary disease (COPD) on prognosis of patients with advanced non-small cell lung cancer (NSCLC).Methods 98 patients with advanced NSCLC were divided into COPD group (41 patients) and non-COPD group (57 patients) according to their lung function results,and the clinical data of the two groups were compared.The survival curve of the patients was plotted by Kaplan-Meier method,and the survival prognoses of the patients under different stratification were were compared.Cox regression analysis was used to explore the risk factors affecting the survival prognosis of the patients with advanced NSCLC.Results The percentage of male and smoking and the level of N-terminal probrain natriuretic peptide (NT-proBNP) in the COPD group were 75.61%,63.41%and (754.34±357.07) ng/L,which were higher than 54.39%,28.07%and (615.26±306.21) ng/L in the non COPD group,and the differences were statistically significant (P<0.05).In both groups,the age,body mass index (BMI),type of pathology,clinical stage,pleural effusion,radiotherapy,targeted therapy,carcinoembryonic antigen (CEA),neuron-specific enolase(NSE) and cytokeratin 19 fragment (Cyfra21-1),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol (HDL-C),total cholesterol,triglyceride,fasting glucose,blood creatinine,blood uric acid,and systolic blood pressure were compared,and the differences were not statistically significant (P>0.05).7 of the98 patients with advanced International Association for the Study of Lung Cancer (IASLC) survived during followup,with a 5-year survival rate of 7.14%(7/98).Among them,2 cases survived in the COPD group,with a 5-year survival rate of 4.88%(2/41);5 cases survived in the non-COPD group,with a 5-year survival rate of 8.77%(5/57).There was no statistically significant difference in the 5-year survival rate between the two groups (P>0.05).Kaplan-Meier survival curve analysis showed that patients with IASLC stageⅣ,male,combined COPD,and NT-proBNP>606.0 ng/L had

关 键 词：非小细胞肺癌 慢性阻塞性肺疾病 生存预后 

分 类 号：R734.2[医药卫生—肿瘤] R563.9[医药卫生—临床医学]