基于SEER数据库的喉癌合并同时性肺癌患者预后影响因素分析

Factors influencing the prognosis of patients with laryngeal cancer combined with simultaneous lung cancer based on the SEER database

目的探讨喉癌合并同时性肺癌患者的预后影响因素以及首诊病种与造成死亡病种之间的关系。方法回顾性分析监测、流行病学和最终结果(SEER)数据库中2004年1月至2015年12月被诊断为喉癌合并同时性肺癌240例患者的临床病理资料。采用χ^(2)检验评估患者首诊病种与造成死亡病种之间的关系;采用Kaplan-Meier法行生存分析;采用Cox比例风险模型对患者总生存的影响因素进行单因素和多因素分析。结果共纳入240例喉癌合并同时性肺癌患者,其中年龄≥65岁141例;男性222例,女性18例。患者首诊的病种与造成死亡的病种无关(χ^(2)=3.31,P=0.191)。患者1、3、5年总生存率分别为62.1%、31.5%、16.4%。单因素分析显示,喉癌原发灶位置、肺癌原发灶位置、肺癌组织学分级、病理学类型、临床分期、手术情况、放疗情况对患者总生存均有影响(均P<0.05);多因素分析显示,喉癌原发灶位置、肺癌原发灶位置、肺癌组织学分级、病理学类型、临床分期、手术情况是患者总生存的独立影响因素(均P<0.05)。结论喉癌合并同时性肺癌患者预后的独立影响因素包括喉癌原发灶位置、肺癌原发灶位置、肺癌组织学分级、病理学类型、临床分期、手术情况。患者首诊病种与造成死亡病种之间不具有相关性。

Objective To explore the prognostic factors and the relationship between the disease type at initial diagnosis and the disease type causing death in patients with laryngeal cancer combined with simultaneous lung cancer.Methods The clinicopathological data of 240 patients diagnosed with laryngeal cancer combined with simultaneous lung cancer between January 2004 and December 2015 in the Surveillance,Epidemiology and End Results(SEER)database were retrospectively analyzed.Chi-square test was used to evaluate the relationship between the disease type at initial diagnosis and the disease type causing death in patients with laryngeal cancer combined with simultaneous lung cancer.Kaplan-Meier method was used for survival analysis,and Cox proportional risk model was used to make univariate and multivariate analysis of the factors influencing the overall survival of patients.Results A total of 240 cases with laryngeal cancer combined with simultaneous lung cancer included 222 males and 18 females,and there were 141 cases aged over 65 years.The disease type at initial diagnosis was not correlated with the disease type causing death of patients(χ^(2)=3.31,P=0.191).The 1-year,3-year,and 5-year overall survival rates of these patients were 62.1%,31.5%,and 16.4%,respectively.Univariate analysis showed that the primary location of laryngeal cancer,primary location of lung cancer,histological grade of lung cancer,pathological type,clinical staging,surgical condition,and radiotherapy influenced the overall survival of patients(all P<0.05);multivariate analysis showed that the primary location of laryngeal cancer,primary location of lung cancer,histological grade of lung cancer,pathological type,clinical stage,and surgical condition were independent influencing factors for overall survival of patients with laryngeal cancer combined with simultaneous lung cancer(all P<0.05).Conclusions The independent factors influencing the prognosis of laryngeal cancer with simultaneous lung cancer patients include the primary focus of laryngeal cancer,the primary focus of lung cancer,the histological grade of lung cancer,the pathological type,the clinical stage,and the surgical condition.And there is no correlation between the disease type at initial diagnosis and the disease type causing death.