体质量指数对Ⅰ～ ⅢA期非小细胞肺癌术后患者预后的影响

Prognostic Impact of Body Mass Index on Postoperative Outcome of Patients with Stage Ⅰ-ⅢA Non-small Cell Lung Cancer

目的探讨体质量指数(body mass index,BMI)对接受手术治疗的非小细胞肺癌(non-small cell lung cancer,NSCLC)患者术后生存预后的影响。方法回顾分析2009～2014年间作者医院收治的236例行手术切除治疗Ⅰ～ⅢA期NSCLC患者的病例资料,计算患者入院时术前BMI,并分析其对术后无病生存期(disease free survival,DFS)和总生存期(overall survival,OS)的影响。中位随访时间为36. 8个月。采用Kaplan-Meier法进行生存分析,Cox回归进行单因素和多因素分析。结果正常BMI组(18. 50≤BMI <24 kg/m^2,n=75)和超重BMI组(24≤BMI <28 kg/m^2,n=161)患者的术后5年DFS(分别为45. 60%、64. 60%,P=0. 045),OS(分别为51. 30%、68. 70%,P=0. 041)比较均存在统计学差异。Cox单因素分析显示,超重BMI组较正常BMI组患者的术后DFS(HR=0. 61,P=0. 047)和OS(HR=0. 24,P <0. 001)获益;多因素分析表明,年龄、BMI和病理N分期是NSCLC术后的独立预后风险因素。结论 BMI是Ⅰ～ⅢA期NSCLC患者的术后独立预后因素之一,高BMI与NSCLC患者的术后生存获益相关。

Objective To investigate the prognostic impact of body mass index(BMI)on postoperative outcome of nonsmall cell lung cancer(NSCLC)patients.Methods A total of 236 patients with stageⅠ-ⅢA NSCLC after surgical resection in author’s hospital between 2009 and 2014 were retrospectively analyzed.The BMI before admission was calculated,and the influences of BMI on the disease free survival(DFS)and overall survival(OS)were evaluated.The median follow-up time was 36.80 months.Kaplan-Meier analysis was used to evaluate the survival rate,and Cox regression was used for the univariate and multivariate analysis.Results There were significantly different in 5-year DFS rates(45.60%vs.64.60%,P=0.045)and OS rates(51.30%vs.68.70%,P=0.041)between normal BMI group(18.50<BMI≤24 kg/m^2,n=75)and overweight BMI group(24<BMI≤28 kg/m^2,n=161).Cox univariate analysis indicated that the survival of normal BMI group was better than that of overweight BMI group(DFS:HR=0.61,P=0.047;OS:HR=0.24,P<0.001).The multivariate analysis showed that age,BMI and pathological N stage were the independent prognosis factors for NSCLC patients.Conclusion BMI is one of the independent prognostic factor of stageⅠ-ⅢA NSCLC patients,and higher BMI is closely associated with better prognosis of NSCLC patients.