肺癌脑转移预后的多因素分析

Multiple Factors Analysis of the Prognosis of Lung Cancer with Brain Metastases

目的：探索肺癌患者脑转移的预后影响因素。方法：回顾性分析我院2001～2010年216例肺癌患者的临床资料。运用SPSS软件包,通过比例风险模型（Cox模型）进行单因素和多因素分析,采用Kaplan-Merer法进行生存分析并描绘生存曲线和进行Log-rank时序检验。结果：通过单因素分析显示PS评分（p=0.006）、脑转移病灶数目（P=0.038）、有无脑转移的症状（P=0.001）、有无颅外器官转移（P=0.037）和治疗方法（P=0.045）等对生存期有影响,而年龄（P=0.887）、性别（P=0.207）、病理类型（P=0.727）、肺癌的部位（P=0.104）、脑转移病灶部位（P=0.401）对生存期无影响。多因素分析显示影响肺癌脑转移预后的主要因素依次为PS评分、有无脑转移的症状和治疗方法,而有无颅外器官转移和脑转移灶的数目等因素被削弱。结论：PS评分、有无颅外器官转移和脑转移病症灶的多少是脑转移肺癌患者的独立预后因素。

Objective： To observe the factors affecting the prognosis of lung cancer with brain metastases. Methods： We retrospectively analyzed the clinical data of 216 patients of lung cancer with brain metastases in our hospital from the year 2001 to 2010. The SPSS software package and the proportional hazards model （Cox model） were used to proceed multiple factors analysis, and the method of Kaplan - Merer, survival curve and Log-rank Test were used to survival analysis. Results： Single factor analysis showed that PS score （P=0.006）, numbers of brain metastases （P=0.038）, symptoms of brain metastases （P=0.001）, presence of extracranial organ metastasis（P=0.037） and treatment（P=0.045） were factors affecting survival. And age（P=0.887）, gender（P=0.207）, pathological type（P=0. 727）, location of cancer（P=0.104）, and position of brain metastases of lung cancer（P=0.401） had no effect on survival. While multi-factor analysis showed that the main factors influencing the prognosis of lung cancer with brain metastasis were PS score, presence of extracranial organ metastasis and the number of brain metastases, while the factors including the symptoms of brain metastases and treatment were weakened. Conclusions： PS score, status of extracranial organ metastasis and number of brain metastases are independent prognosis factors for lung cancer with brain metastases.