原发性肺癌患者术后生存分析及影响因素评估

Analysis of postoperative survival and assessment of influencing factors for patients with primary lung cancer

目的研究原发性肺癌患者的术后生存情况并评估影响术后生存的因素。方法回顾性分析2008年3月~2010年8月期间在我院住院治疗的肺癌患者作为研究对象,收集病案资料并随访术后的生存情况。结果本次研究中1、3、5年的生存率为66.67%、32.05%、14.10%,中位生存期为18.6个月;单因素log-rank分析表明肿瘤家族史（χ2=7.073,P=0.042）、疾病检出方式（χ2=20.082,P=0.012）、淋巴转移（χ2=13.051,P=0.018）、临床分期（χ2=12.052,P=0.019）、治疗方式（χ2=10.262,P=0.020）等对生存率具有显著的影响;Cox多元回归分析的结果表明：检出方式（RR=4.132,95%CI：1.732~8.060）、是否淋巴转移（RR=3.024,95%CI：1.554~6.234）、临床分期较晚（RR=2.802,95%CI：1.572~5.903）、治疗方式（RR=2.487,95%CI：1.421~6.022）是影响原发性肺癌生存的重要因素。结论早期发现和诊疗、是否转移、治疗方式等因素是影响原发性肺癌术后生存的重要因素,应加强对肺癌的早期筛查,以提高患者的生存时间。

Objective To investigate postoperative surviving conditions of patients with primary lung cancer and to eval- uate factors influencing postoperative survival. Methods The study adopted the method of retrospective study. Patients with lung cancer who were hospitalized in our hospital from March 2008 to August 2010 were collected as research subjects. Medical records were collected and postoperative surviving conditions were followed-up. Results 1-year, 3- year and 5-year survival rates in this study were 66.67%, 32.05% and 14.10% respectively, and the median survival time was 18.6 months; single-factor log-rank analysis showed that family history of cancer （X2=7.073, P=0.042）, detec- tion methods of diseases （X2=20.082, P=0.012）, lymphatic metastasis （X2=13.051, P=0.018）, clinical stages （X2=12.052, P=0.019）, and treatment methods （~2=10.262, P=0.020） had significant effects on survival rate; results of Cox multiple regression analysis showed that detection methods （RR=4.132, 95%CI：1.732-8.060）, whether lymphatic metastasis had occurred （RR=3.024, 95%CI：1.554-6.234）, late clinical stage （RR=2.802, 95%CI：1.572-5.903）, and treatment methods （RR=2.487, 95%CI：1.421-6.022） were significant factors influencing the survival of primary lung cancer. Conclusion Early detection and treatment, whether the cancer has metastasized, and treatment methods are significant factors influ- encing postoperative survival of primary lung cancer. Early screening of lung cancer should be strengthened so as to prolong patients＂ survival time.