青岛地区非小细胞肺癌术后预后影响因素的队列研究

Cohort study on influencing factors of postoperative prognosis of non-small cell lung cancer patients in Qingdao

目的探讨非小细胞肺癌(NSCLC)患者围手术期营养、炎症、血栓、生理状态和心理对预后的影响。方法收集青岛地区5个研究中心116例手术切除的NSCLC治疗情况。观察指标为患者术前的营养、炎症、血栓、心理及生理状态和术后1个月血肿瘤标记物含量。预后指标选择1年生存率、2年生存率、生存时间和无进展生存时间(PFS)。采用SPSS 10.0软件包进行处理,Kaplan-Meier绘制生存曲线,采用COX回归比例风险模型进行单因素及多因素分析。结果 (1)COX比例风险模型单因素检验结果显示,血清白蛋白、血浆D-二聚体、C反应蛋白、血肿瘤标志物、生活应激、抑郁状态、ZPS评分影响患者2年的整体生存率,差异有统计学意义;(2)血清白蛋白、血浆D-D聚体、血C反应蛋白、术后血肿瘤标记物、生活应激和ZPS评分影响患者2年无进展生存率,差异有统计学意义;(3)对单因素检验结果有统计学意义的项目进行COX比例风险模型多因素检验,ZPS评分≤2分和血清白蛋白>35.0 g/L可以增加患者2年无进展生存率及2年整体生存率,差异有统计学意义;(4)术后血肿瘤标记物升高或不降低和抑郁状态降低患者2年无进展生存率差异有统计学意义。结论在手术切除的NSCLC患者中,ZPS评分≤2分和血清白蛋白>35.0 g/L可以增加患者2年无进展生存率和2年整体生存率,术后血肿瘤标记物升高或不降低和抑郁状态降低患者2年无进展生存率。

Objective To study the influence on prognosis about the patients with non-small cell lung cancer （NSCLC） perioperative nutrition, inflammation, thrombus, physiology and the psychological. MethodsTo collect treatment situation of 116 cases NSCLC who surgically resected from five research centers in Qingdao. To observe patients with preoperative nutritional, inflammation, thrombus, psychological and physiological state and blood tumor markers in postoperative 1 months. Prognostic indicators for 1 year survival rate, 2 year survival rate, survival time and progression-free survival （PFS）. Using SPSS10.0 software package for processing, Kaplan Meier-survival curve drawing, using COX proportional hazards regression model for the single factor and multi-factor analysis. Results 1. COX proportional hazards model of single factor test results show that the serum albumin and plasma D-dimer, c-reactive protein and blood tumor markers, life stress, depression, ZPS score influence patients 2 years of overall survival, the difference have statistical significance; 2. Serum albumin and plasma D-D dimer, blood c-reactive protein, postoperative blood tumor markers, life stress and ZPS score influence patients 2 years of progression-free survival, difference have statistical significance ; 3. On single factor test results had statistical significance of the project to test multi-factors COX proportional hazards model, ZPS score 2 minutes or less and serum albumin increased patients 2 years 〉 35.0g/L progression-free survival and overall survival, 2 years, difference had statistically significance; 4. Postoperative increase or reduce blood tumor markers and reducing depression patients 2 years progression-free survival difference was statistically significant. Conclusions In surgically resected NSCLC patients, ZPS score two points or less 〉 35.0 g/L and serum albumin can increase patients 2 years of progression-free survival and overall 2 years survival rate;postoperative blood tumor markers elevated or dont reduce and depression reduce 2 years of progression-free survival.