以心包积液为首发症状的非小细胞肺癌预后影响因素分析

Analysis on Prognostic Influencing Factors of Non-small Cell Lung Cancer with Pericardial Effusion as the FirstSymptom

目的:探讨以心包积液为首发症状的非小细胞肺癌(Non-small cell lung cancer,NSCLC)患者的预后及其影响因素。方法:回顾性分析2013年4月—2016年4月间福建省立医院收治的25例以心包积液为首发症状的NSCLC的临床资料,采用Kaplan-Meier法分析年龄、性别、T分期、N分期、其他脏器转移、原发病灶位置、胸腔积液、病理类型、表皮生长因子受体(Epidermal growth factor receptor,EGFR)基因状态、治疗方法与总生存期(Overall survival,OS)的关系,同时多因素采用Cox回归模型分析影响患者OS的独立因素。结果:总的中位OS为9个月,1年生存率为28%。单因素分析结果显示性别、病理类型、治疗方法为影响患者OS的因素,多因素分析显示病理类型、治疗方法为影响患者OS的独立因素。结论:在以心包积液为首发症状的NSCLC中,病理类型、治疗方法为独立预后因素,腺癌、接受表皮生长因子受体—酪氨酸激酶抑制剂靶向治疗的患者可获得较长的生存。

Objective:To investigate the prognosis and its influencing factors of non-small cell lung cancer(NSCLC)patientswith pericardial effusion as the first symptom.Methods:The clinical records of 25 non-small cell lung cancer with pericardial effusion as the first symptom at Fujian Provincial Hospital during April 2013 and April 2016 were retrospectively analyzed.The Kaplan-Meier method was used to evaluate overall survival(OS).The median OS was analyzed among different factors,including age,gender,T stage,N stage,other organs of the transfer,primary tumor location,pleural effusion,pathological type,epidermal growth factor receptor(EGFR)gene status and treatment methods.The multivariate Cox regression analysis was used to evaluate the independent factors affecting OS of patients.Results:The median OS was 9 months,the 1-year survival rate was 28%.The univariate analysis showed that gender,pathological type and treatment methods were prognostic factors affecting OS of patients.Multivariate analysis showed that the independent prognostic factors affecting OS of patients were pathological type and treatment methods.Conclusion:Pathological type and treatment methods are independent prognostic factors in NSCLC patients with pericardial effusion as the first symptom.The patients with lung adenocarcinoma and accepting epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs)targeted therapy have longer survival.