Ⅳ期非小细胞肺癌预后因素分析

Prognostic factors in patients with stage Ⅳ non-small cell lung cancer

目的:回顾分析Ⅳ期非小细胞肺癌患者(NSCLC)的预后因素,指导临床个体规范化的治疗。方法:采用Kaplan Meier生存分析以及COX回归模型分析57例Ⅳ期初治NSCLC患者临床特征,如年龄、性别、吸烟指数、病理类型以及治疗前血浆中CEA和Cyfra21-1的水平等以及治疗相关因素与生存率的关系,筛选Ⅳ期NSCLC患者预后相关因素。结果:单因素分析表明,患者的年龄、吸烟指数、KPS评分、治疗前血浆Cyfra21-1水平以及化疗与否、化疗周期数与Ⅳ期NSCLC患者的生存率有关。多因素分析表明,Cyfra21-1、KPS评分、化疗周期是独立的预后因素。结论:治疗前血浆中Cyfra21-1的水平,KPS评分以及化疗周期数为Ⅳ期NSCLC患者的独立预后因素。无化疗禁忌症的Ⅳ期NSCLC患者积极规范合理的治疗能延长患者生存期,具有重要的临床意义。

Objective：To investigate the prognostic factors in non-small cell lung cancer（NSCLC） at stage Ⅳ for exploring the individual treatment.Methods：Kaplan Meier survival analysis and Cox regression model were used to analyze the relationship between the prognostic factors and survival time in 57 cases of NSCLC patients at stage Ⅳ.The prognostic factors included clinical-pathological features,serum levels of cytokeratin fragment 19（Cyfra2121） and CEA,and therapeutic features,in order to single out the independent prognostic factors related to the NSCLC patients at stage Ⅳ.Results：Among 57 cases of NSCLC at stage Ⅳ,Kaplan Meier analysis showed that age,smoking index,Karnofsky performance status,Cyfra21-1,treament were related to prognosis.Multivariate analysis indicated that Cyfra21-1,Karnofsky Score,the cycles of chemotherapy were independent prognostic factors.Conclusion：The serum levels cytokeratin fragment 19,Karnofsky performance status,KPS score and cycles of chemotherapy were independent prognostic factors of NSCLC patients at stage Ⅳ.