非小细胞肺癌罕见转移分布与预后的相关性分析

Correlation Between Distribution and Prognosis of Rare Metastases in Non-small Cell Lung Cancer

目的探讨罕见转移对非小细胞肺癌患者临床特征及预后的影响。方法选取2011年6月至2016年6月于成都医学院第一附属医院确诊的767例Ⅳ期非小细胞肺癌患者为研究对象。将除大脑、骨骼、肝脏、肾上腺、胸腔、远处淋巴结转移以外的远处转移定义为罕见转移。分析常见转移与罕见转移之间的临床特征及预后差异。结果共有93例患者被诊断出罕见转移,相应的解剖部位有软组织、肾脏、胰腺、脾脏、小肠、腹膜、骨髓、眼、扁桃体、鼻腔、卵巢、甲状腺、心脏和乳房。通过多因素分析结果风险比(HR 1.31;95%CI:1.085～1.708)显示,罕见转移为预后不良的危险因素。结论非小细胞肺癌转移到以上所提及的部位非常少见,罕见转移的出现提示预后不良。

Objective To investigate the effect of rare metastases on the clinical characteristics and prognosis of patients with non-small cell lung cancer(NSCLC).Methods A total of767cases with stage IV NSCLC treated in The First Affiliated Hospital of Chengdu Medical College from June of2011to June of2016were selected in the study.The distant metastases other than the metastases to the brain,bone,liver,adrenal gland,thoracic cavity and distant lymph node were defined as rare metastases.The characteristics and prognostic differences of the common and rare metastases were analyzed.Results A total of93patients were diagnosed with rare metastases,and the corresponding anatomical sites included soft tissue,kidney,pancreas,spleen,small intestine,peritoneum,bone marrow,eye,tonsil,nasal cavity,ovary,thyroid,heart and breast.The hazard ratio(HR1.31;95%CI:1.085~1.708)of the multivariate analysis showed that the rare metastasis was a risk factor for prognosis.Conclusion The NSCLC metastases to the sites mentioned above are very rare and the rare metastasis suggests poor prognosis.