术前肺功能参数与老年非小细胞肺癌患者预后的关系

Relationship between preoperative pulmonary function parameters and prognosis of elderly patients with NSCLC

目的探讨术前肺功能参数与老年非小细胞肺癌(NSCLC)患者预后的关系。方法以术后3年作为观察期限,根据预后情况将行手术治疗的95例老年NSCLC患者分为存活组(n=42)和死亡组(n=53)。比较两组患者的手术方式、病理学分期、病理学类型、术后化疗情况、术前肺功能参数等临床特征,采用多元Cox回归分析模型对NSCLC患者预后的影响因素进行分析。结果存活组和死亡组NSCLC患者的病理学分期、术后化疗情况及术前肺活量(VC)、最大通气量(MVV)、用力肺活量(FVC)、第一秒用力呼气容积(FEV1)、肺一氧化碳弥散量(DLCO)测定值比较,差异均有统计学意义(P﹤0.05);多因素分析结果显示:病理学分期升高、术前FEV1降低是NSCLC患者术后生存率降低的独立危险因素(P﹤0.05),术后化疗是NSCLC患者术后生存率提高的独立保护因素(P﹤0.05)。结论NSCLC患者术后生存率受到多种因素的影响,而术前FEV1降低是NSCLC患者术后生存率降低的独立危险因素之一。

Objective To investigate the relationship between preoperative pulmonary function parameters and prognosis of elderly patients with non-small cell lung cancer(NSCLC).Method According to the prognosis,95 elderly patients with NSCLC were divided into survival group(n=42)and death group(n=53),the observation period was 3 years.The clinical characteristics of operation mode,pathological stage,pathological type,postoperative chemotherapy and preoperative pulmonary function parameters were compared between the two groups.Multivariate Cox regression model was used to analyze the prognostic factors of NSCLC patients.Result There were significant differences in pathological stage,postoperative chemotherapy proportion,preoperative vital capacity(VC),maximum voluntary ventilation(MVV),forced vital capacity(FVC),forced expiratory volume in one second(FEV1)and diffusion capacity of carbon monoxide of lung(DLCO)between survival group and death group(P<0.05).Multivariate analysis showed that the increase of pathological stage and the decrease of preoperative FEV1 were independent risk factors for the decrease of survival rate of NSCLC patients(P<0.05),and postoperative chemotherapy was a protective factor for the improvement of survival rate of NSCLC patients(P<0.05).Conclusion Postoperative survival rate of patients with NSCLC is affected by many factors.Preoperative reduction of FEV1 is one of the independent risk factors for postoperative survival rate reduction of patients with NSCLC.