肺癌晚期骨转移患者预后因素分析:基于SEER数据库的回顾性研究

Analysis of Prognostic Factors in Patients with Advanced Bone Metastases from Lung Cancer:A Retrospective Study Based on Seer Database

目的比较肺癌晚期患者骨转移与其他远端转移患者的生存差异,分析患者的临床特征,探究影响肺癌晚期骨转移患者预后的独立因素,找到发生骨转移的相关危险因素。方法回顾性分析美国医疗保险监督、流行病学和最终结果(SEER)数据库2010年1月至2014年1月确诊的Ⅳ期肺癌患者共18879例临床资料,开展对真实世界的研究(RWS),找到影响骨转移患者预后的独立因素,发现发生骨转移的相关因素。结果比例风险回归模型(COX)回归:种族、性别、诊断年龄、形态学分型、组织学分级、T分期、N分期、远端部位手术情况与患者的总生存时间(OS)相关,差异有统计学意义(P<0.05);二元Logistic回归:种族、性别、诊断年龄、形态学分型、T分期、N分期、原发部位及远端部位手术情况对肺癌晚期患者发生骨转移有统计学意义(P<0.05)。结论性别、诊断年龄、形态学分型、组织学分级、T分期、N分期、远端部位手术情况是影响肺癌晚期骨转移患者预后的独立因素;种族、性别、诊断年龄、形态学分型、T分期、N分期、原发部位及远端部位手术情况是肺癌晚期患者发生骨转移的相关危险因素。

Objective To compare the survival differences of patients with bone metastasis and other distal metastases in advanced lung cancer,analyze the clinical characteristics of patients,explore the independent factors affecting the prognosis of patients with bone metastasis in advanced lung cancer,and find out the relevant risk factors for bone metastasis.Methods The clinical data of 18879 patients with stage IV lung cancer diagnosed in SEER database from January 2010 to January 2014 were retrospectively analyzed,and a real-world study(RWS)was carried out to find the independent factors affecting the prognosis of patients with bone metastasis,and the related factors of bone metastasis were found.Results Cox regression:race,sex,age at diagnosis,morphological type,histological grade,T stage,N stage,distal surgery were correlated with the overall survival time(OS),with statistical significance(P<0.05);binary logistic regression:race,sex,age at diagnosis,morphological classification,T stage,N stage,primary site and distal site of surgery for advanced lung cancer patients with bone metastasis were statistically significant(P<0.05).Conclusion Gender,age at diagnosis,morphological type,histological grade,T stage,N stage,and distal surgery are independent factors affecting the prognosis of patients with advanced bone metastasis of lung cancer.Race,sex,age at diagnosis,morphological type,T stage,N stage,primary site and distal site of surgery are related risk factors for bone metastasis in patients with advanced lung cancer.