70例复合型小细胞肺癌临床分析

Clinical analysis of 70 patients with combined small-cell lung cancer

目的探讨复合型小细胞肺癌的临床病理特点及其与患者预后关系,同时分析目前治疗现状。方法采用回顾性研究方法分析2000年3月至2010年3月接受治疗的70例复合型小细胞肺癌患者资料,COX风险回归模型进行多因素分析,Kaplan-Meie进行生存分析,Log-rank单因素预后分析。结果 1年生存率为68.6%,3年生存期为57.1%,5年生存率为31.4%。本组的OS为0.2-88.9个月,中位OS为27.8个月。Log-rank单因素分析显示:性别、肿瘤直径、分期,KPS评分是本组影响OS预后因素。COX风险回归模型多因素分析显示:只有TNM分期为独立影响预后因素。59例患者进行了综合治疗,采用铂类药物的联合化疗方案为目前主要治疗方式,采用非小细胞化疗方式与小细胞化疗方式对总生存期无统计学差异(P>0.05)。结论复合型小细胞肺癌是一种特殊类型的肺癌,TNM分期为患者独立不良预后因素。

Objective To explore the clinical pathological characteristics of combined small cell lung cancer and its relationship with the prognosis of patients. Methods From March 2000 to March 2010, the clinical data of 70 patients with combined small cell lung cancer were retrospectively analyzed. The COX regression model was used to analyze the independent factors affecting OS, and the Kaplan Meier method was used to calculate the survival rate, and the Log-rank test was used to analyze the single factor prognosis. Results The 1-year survival rate was 68. 6% , the 3-years survival rate was 57. 1% , and the 5 -year survival rate was 3 1 .4% . The Log-rank analysis showed that sex, tumor diameter, staging, KPS score influenced the prognosis of OS. Cox regression model analysis showed that only TNM stage was the independent prognostic factor influencing the OS of combined small cell lung cancer patients. 59 patients received the multimodality treatment. Platinum-based chemotherapy was the main treatment. There was no significant difference in OS rate between patients under conventional SLCL regimens and NSLCL regiments （ P 〉 0. 05）. Conclusion Combined small cell lung cancer is a special type of lung cancer, and TNM stage is the inde-pendent prognostic factor influencing the OS of combined small cell lung cancer patients.