不同病理类型肺癌脑转移患者的临床特征及合并脑出血的危险因素分析

Clinical features of patients with different pathological types of lung cancer and brain metastases and the risk factors of cerebral hemorrhage

目的探讨不同病理类型肺癌与脑转移的临床特征,并分析合并脑出血的危险因素。方法回顾性分析萍乡矿业集团有限责任公司总医院2017年5月~2019年5月收治的370例肺癌脑转移患者的临床资料,分析不同病理类型肺癌与脑转移的临床特征及脑出血影响因素。结果不同病理类型(鳞癌、腺癌、小细胞癌、大细胞癌及腺鳞癌)肺癌脑转移患者的颅内病灶分布、合并出血情况及病灶密度特征比较,差异有统计学意义(P<0.05)。按照是否合并脑出血将患者划分为出血组(n=154)和未出血组(n=216)。单因素分析结果显示,出血组的多发病灶、瘤高密度或混杂密度占比高于非出血组,差异有统计学意义(P<0.05);多因素分析结果显示,多发病灶(β=1.959,OR=7.091,95%CI=4.442~11.320)、瘤高密度或混杂密度(β=0.740,OR=2.095,95%CI=1.376~3.190)是肺癌脑转移患者脑出血的危险因素(P<0.05)。结论不同病理类型肺癌患者脑转移临床特征不同,可通过患者临床特征预估脑出血风险。

Objective To investigate the clinical features of different pathological types of lung cancer and brain metastases,and to analyze the risk factors of cerebral hemorrhage.Methods The clinical data of 370 patients with lung cancer and brain metastases who were treated in the General Hospital of Pingxiang Mining Group Co.,Ltd.from May 2017 to May 2019 were retrospectively analyzed.The clinical features of different pathological types of lung cancer and brain metastases and the influencing factors of cerebral hemorrhage were analyzed.Results There were significantly statistical differences in the distribution of intracranial lesions,combined hemorrhage and density of lesion among the patients with different pathological types(squamous cell carcinoma,adenocarcinoma,small cell carcinoma,large cell carcinoma,adenosquamous carcinoma)of lung cancer and brain metastases(P<0.05).The patients were divided into the hemorrhage group(n=154)and the non-hemorrhage group(n=216)according to the hemorrhage of patients.The results of single-factor analysis showed that the proportions of high density or mixed density of multiple lesions and tumor in the hemorrhage group were higher than those in the non-hemorrhage group,the differences were statistically significant(P<0.05).Multiple-factor analysis showed that the high density or mixed density of multiple lesions(β=1.959,OR=7.091,95%CI=4.442-11.320)and tumor(β=0.740,OR=2.095,95%CI=1.376-3.190)were the risk factors of cerebral hemorrhage in patients with lung cancer and brain metastases(P<0.05).Conclusion The lung cancer patients with different pathological types have different clinical features of brain metastases,and the risk of cerebral hemorrhage can be estimated based on the clinical features of patients.