非小细胞肺癌脑转移高危因素分析  

Analysis of high-risk factors for brain metastasis in non-small cell lung cancer

作　　者：周开甲[1] 周冰 陈泽磊 陈昭芳 陈婷 陈溥 张鸿辉 ZHOU Kaijia;ZHOU Bing;CHEN Zelei;CHEN Zhaofang;CHEN Ting;CHEN Pu;ZHANG Honghui(Department of Neurotumor Surgery,Clinical Oncology School of Fujian Medical University/Fujian Cancer Hospital/Fudan University Affiliated Cancer Hospital Fujian Hospital,Fuzhou,Fujian 350001,China;School of Basic Medicine,Fujian Medical University,Fuzhou,Fujian 350001,China;School of Computer Science,Fuzhou University,Fuzhou,Fujian 350001,China)

机构地区：[1]福建医科大学肿瘤临床医学院/福建省肿瘤医院/复旦大学附属肿瘤医院福建医院神经肿瘤外科,福建福州350001 [2]福建医科大学基础医学院,福建福州350001 [3]福州大学计算机学院,福建福州350001

出　　处：《现代医药卫生》2024年第20期3459-3463,共5页Journal of Modern Medicine & Health

基　　金：福建省卫生健康委员会科技计划项目(中青年骨干人才培养项目)(2021GGA044);福建省自然科学基金项目(2023J011255);2024年度福建医科大学大学生创新创业训练计划项目(创新训练项目、一般项目)(C2024072)。

摘　　要：目的分析影响非小细胞肺癌(NSCLC)脑转移的高危因素。方法回顾性分析2020-2024年福建医科大学肿瘤临床医学院/福建省肿瘤医院/复旦大学附属肿瘤医院福建医院收治的258例NSCLC患者的性别、年龄等临床及病理类型、分子病理信息,结合采用的治疗方式,综合分析影响NSCLC脑转移的高危因素。结果(1)年轻、女性患者,EGFR突变及ALK基因重排NSCLC患者,脑转移发生率上升。(2)年轻NSCLC患者出现脑膜转移的风险较高,EGFR突变NSCLC患者出现脑膜转移的风险显著增加。(3)针对NSCLC脑转移患者,在靶向治疗的基础上,配合脑部放疗、抗肿瘤血管生成及免疫治疗;而如果患者出现脑膜转移,在靶向治疗的基础进行抗肿瘤血管生成治疗。结论NSCLC脑转移的高危因素包括年轻、女性、EGFR突变及合并ALK重排突变。通过早期识别和干预这些高危因素,有助于提高NSCLC脑转移患者的生存率和生活质量。Objective To analyze the high-risk factors of brain metastasis in non-small cell lung cancer(NSCLC).Methods A retrospective analysis was conducted on 258 NSCLC patients admitted to Clinical Oncology School of Fujian Medical University/Fujian Cancer Hospital/Fudan University Affiliated Cancer Hospital Fujian Hospital,including their gender,age,clinical and pathological types,molecular pathological information,and combined with the treatment methods used,to comprehensively analyze the high-risk factors of brain metastasis of NSCLC.Results(1)The incidence of brain metastasis increased in the young and female patients,as well as the non-small cell patients with EGFR mutations and ALK gene rearrangements.(2)The young NSCLC patients had a higher risk of meningeal metastasis,while the EGFR mutated NSCLC patients had a significantly increased risk of meningeal metastasis.(3)For the NSCLC patients with brain metastases,targeted therapy was combined with brain radiation therapy,anti-tumor angiogenesis,and immunotherapy;if the patient developed meningeal metastasis,anti-tumor angiogenesis therapy should be performed on the basis of targeted therapy.Conclusion High-risk factors for brain metastasis in NSCLC include youth,femininity,EGFR mutations,and concomitant ALK rearrangement mutations.Early identification and intervention of these high-risk factors can help improve the survival rate and quality of life of NSCLC patients with brain metastases.

关 键 词：非小细胞肺癌 高危因素 脑转移 治疗方式 预后 

分 类 号：R734.2[医药卫生—肿瘤]