可手术的非小细胞肺癌患者贫血的发生和预后的生存分析

Correlation between Pre-treatment Anemia and Prognosis in Non-small Cell Lung Cancer Patients

背景与目的非小细胞肺癌(non-small cell lung cancer,NSCLC)患者可发生贫血,然而贫血是否为NSCLC患者预后的独立因素之一,仍存在争议,故本文研究可手术的NSCLC患者贫血的发生情况和影响预后的因素。方法对广州医学院第一附属医院2000年1月-2008年12月住院的1018例NSCLC患者进行回顾性分析,分析NSCLC手术患者贫血的发生情况以及影响预后的因素。结果患者术前贫血发生率为252/1018(24.1%),无贫血患者总生存时间为(2425.98±50.03)天;贫血患者的总生存时间是(2107.15±93.86)天,有无贫血患者的总生存时间存在明显差异(P=0.001)。Kaplan-Meier生存分析显示I期NSCLC有无贫血患者的生存时间存在显著差异(P<0.001),但是在II期(P=0.310)和IIIa期(P=0.458)患者中,生存时间无明显差异,且I期、II期和IIIa期的NSCLC患者累积生存时间存在统计学差异。Cox回归分析结果显示NSCLC患者的TNM分期、性别、肿瘤大小、是否淋巴结转移均与预后显著相关。结论贫血可以作为NSCLC可手术患者的预后相关因素之一,但在I期NSCLC患者中是独立的预后因素。

Background and objective The patients with non-small cell lung cancer （NSCLC） might contract anemia, however, whether anemia is one of the independent prognostic factors to the patients with NSCLC is still controversial. So the aim of this study is to investigate the correlation between anemia and overall survival （OS） in patients with NSCLC. Methods 1 018 patients with operable NSCLC were retrospectively analyzed in our hospital from January 2000 to December 2008. Results The occurrence of anemia before operation was 252/1 018 （24.1%）. The OS in NSCLC patients without anemia was （2 425.98±50.03） days, and the OS in patients with anemia was （2 107.15±93.86） days. There was significant difference in the OS between them （P=0.001）. The patients with anemia in stage I had shorter survival time than those without anemia （P0.001）. But there was no difference in other stage patients. TNM stage, gender, tumor size and lymph nodes metastasis were correlated with OS using Cox regression analysis. Conclusion Anemia is correlated with survival in operable NSCLC patients. Moreover, it is an independent prognostic factor in NSCLC patients with stage I.