155例复发小细胞肺癌患者首诊临床特征分析

Baseline clinical characteristics of 155 cases of recurrent small cell lung cancer

目的探讨小细胞肺癌(SCLC)一线含铂方案治疗后短期内疾病复发进展的相关临床因素。方法对2009年1月至2013年12月于大连医科大学附属第二医院接受一线含铂方案治疗的SCLC病例进行回顾性分析,根据疾病复发进展时间将病例分为难治复发组和敏感复发组,分析比较两组病例首诊临床特征。结果相比敏感复发组病例,难治复发组病例更多见于首诊时广泛期、肝转移、骨转移、LDH(乳酸脱氢酶)>300U/L、NSE(神经元特异性烯醇化酶)>65.2ng/mL、CYFRA21-1(细胞角蛋白19片段)>9.9ng/mL的患者。Logistic多因素相关性分析显示,广泛期是SCLC一线含铂方案治疗后短期内疾病复发进展的独立影响因素(OR=4.1,[95%CI:1.731-9.740],P=0.001)。结论广泛期是SCLC一线含铂方案治疗后短期内疾病复发进展的独立影响因素,首诊广泛期的SCLC患者,要注意一线含铂方案治疗后疾病短期内复发进展可能。

Objective To determine the predictors associated with short-term recurrence of small cell lung cancer（SCLC）after first-line platinum-based chemotherapy.Methods A retrospective analysis was conducted on the SCLC patients who received first-line platinum-based chemotherapy from January 2009 to December2013.According to the recurrence time,the patients were divided into ＂refractory＂ group or ＂sensitive＂ group.The differences in baseline characteristics were compared between the two groups.Results Compared with those in ＂sensitive＂ group,more patients in the ＂refractory＂ group had extensive disease,liver metastasis,bone metastasis,LDH〉300U/L,NSE〉65.2ng/mL,and/or CYFRA21-1〉9.9ng/mL.Logistic regression analysis showed that the only predictor for short-term recurrence of SCLC was extensive disease（Odds Ratio4.1,[95%CI：1.731-9.740],P=0.001）.Conclusion The extensive disease is the independent factor associated with the recurrence of SCLC after first-line platinum-based chemotherapy.