78例小细胞肺癌患者脑转移发生时间的相关因素初步研究

Preliminary study on the relative factors of the time for brain metastasis in 78 small cell lung cancer

目的:对小细胞肺癌患者发生脑转移时间的影响因素进行分析。方法:统计78例发生脑转移的小细胞肺癌患者的临床资料,采用住院观察和电话形式进行随访,应用卡方检验进行单因素分析,行Logistic多因素分析,得出独立危险因素。结果:单因素分析显示,患者发生脑转移的时间与确诊时分期(χ~2=7.657,P=0.006)、确诊时血清NSE水平(χ~2=5.200,P=0.023)、是否行预防性全脑照射(PCI)治疗(χ~2=5.200,P=0.023)和是否行手术切除治疗(χ~2=3.989,P=0.046)有关。多因素分析显示,广泛期和未行PCI治疗是小细胞肺癌较早发生脑转移的独立危险因素。结论:广泛期和未行PCI治疗的小细胞肺癌患者更易较早发生脑转移,采用PCI治疗后可延迟发生脑转移的时间。对小细胞肺癌患者病灶及症状得到控制后,应尽早行PCI治疗。

Objective：To evaluate influencing factors on the time that patients ocurre brain metastasis in small cell lung cancer.Methods：Clinical data of 78 patients with brain metastasis in small cell lung cancer were collected,followed up by telephone interview and hospitalization observation.Using Chi-square univariate analysis was conducted to obtain the independent risk factors by the multivariate logistic analysis.Results：Single factor analysis showed that the time of brain metastasis in small cell lung cancer patients was related with diagnosis staging（χ^2=7.657,P=0.006）,the level of serum NSE in diagnosis（χ^2=5.200,P=0.023）,PCI treatment（χ^2=5.200,P=0.023） and surgery（χ^2=3.989,P=0.046）.The multivariate analysis concluded that ED-SCLC and without PCI were the independent risk factors for early brain metastasis in small cell lung cancer.Conclusion：The patients who were ED-SCLC or treated without PCI were more likely to occur early brain metastasis.However,patients treated with PCI can delay the time of brain metastasis.When patients are in stable situation,we should reco mmend tailored PCI as soon as possible