新辅助化疗的非小细胞肺癌患者术后肿瘤复发的危险因素分析  

Analysis of risk factors for postoperative tumor recurrence in patients with non-small cell lung cancer receiving neoadjuvant chemotherapy

作　　者：崔艳丽[1] 许淑蕾 廖君[1] Cui Yani;Xu Shuei;Liao Jun(Department of Oncology,Xinjiang Uygur Autonomous Region People’s Hospital,Urumqi Xinjiang 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院肿瘤科,新疆乌鲁木齐830001

出　　处：《中国医刊》2025年第3期265-268,共4页Chinese Journal of Medicine

基　　金：新疆维吾尔自治区自然科学基金(2020D01C425)。

摘　　要：目的分析术前接受新辅助化疗(NACT)的非小细胞肺癌(NSCLC)患者术后肿瘤复发的危险因素。方法选取2021年2月至2023年2月于新疆维吾尔自治区人民医院术前接受NACT的111例NSCLC患者为研究对象,根据术后肿瘤是否复发将研究对象分为复发组(发生局部区域复发或远处转移,28例)和未复发组(未发生局部区域复发或远处转移,83例)。比较分析两组患者的临床资料、肿瘤病理特征、治疗相关指标、术后血清肿瘤标志物水平。采用多因素logistic回归方法分析接受NACT的NSCLC患者术后肿瘤复发的独立影响因素。结果复发组患者的NSCLC家族史比例、临床分期为Ⅱ期和Ⅲ期比例、合并脉管癌栓比例以及术后血清神经元特异性烯醇化酶(NSE)、鳞状细胞癌抗原(SCCA)、癌胚抗原水平均高于未复发组,淋巴结清扫个数、术后放化疗比例、NACT周期均低于或短于未复发组,差异均有统计学意义(P<0.05)。多因素logistic回归分析结果显示,淋巴结清扫个数、NACT周期、术后放化疗是接受NACT的NSCLC患者术后肿瘤复发的独立保护因素(P<0.05),NSE、SCCA是接受NACT的NSCLC患者术后肿瘤复发的独立危险因素(P<0.05)。结论术后未接受放化疗、淋巴结清扫个数较少、NACT周期较短以及术后NSE、SCCA水平较高的NSCLC患者术后肿瘤复发风险更高。Objective To analyze the risk factors of postoperative tumor recurrence in patients with non-small cell lung cancer(NSCLC)receiving preoperative neoadjuvant chemotherapy(NACT).Method A total of 111 NSCLC patients who received preoperative NACT in Xinjiang Uygur Autonomous Region People’s Hospital from February 2021 to February 2023 were selected as the study subjects.According to whether the tumor recurred after surgery,they were divided into recurrence group(28 cases with local regional recurrence or distant metastasis)and non-recurrence group(83 cases without local regional recurrence or distant metastasis).Clinical data,tumor pathological features,treatment-related indexes and postoperative serum tumor markers in the two groups were compared and analyzed.Multivariate logistic regression was used to analyze the independent influencing factors of postoperative tumor recurrence in NSCLC patients receiving NACT.Result The proportion of family history of NSCLC,the proportion of clinical stageⅡandⅢ,the proportion with vascular cancer thrombus,and the levels of postoperative serum NSE,SCCA,CEA in recurrence group were higher than those in the non-recurrence group,and the number of lymph node dissection,the proportion of postoperative radiotherapy and chemotherapy,the NACT cycle in recurrence group were lower than those in the non-recurrence group,with statistical significance(P<0.05).Multivariate logistic regression analysis showed that the number of lymph node dissection,NACT cycle,postoperative radiotherapy and chemotherapy were independent protective factors for postoperative tumor recurrence in NSCLC patients receiving NACT(P<0.05),and NSE and SCCA were independent risk factors for postoperative tumor recurrence in NSCLC patients receiving NACT(P<0.05).Conclusion Patients with NSCLC who did not receive postoperative radiotherapy and chemotherapy,with fewer lymph node dissection,shorter NACT cycle,and higher postoperative NSE and SCCA levels had a higher risk of postoperative tumor recurrence.

关 键 词：新辅助化疗 非小细胞肺癌 肿瘤复发 危险因素 

分 类 号：R734.2[医药卫生—肿瘤]