[1]李 莎),吴 静),胡亚辉),等.Ⅳ期肺腺癌初诊时转移特征和生存分析*[J].郑州大学学报(医学版),2017,(04):443-447.[doi:10.13705/j.issn.1671-6825.2017.04.017]
 LI Sha),WU Jing),HU Yahui),et al.Features of initially presenting metastases and survival analysis in patients with stage Ⅳ lung adenocarcinoma[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2017,(04):443-447.[doi:10.13705/j.issn.1671-6825.2017.04.017]
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Ⅳ期肺腺癌初诊时转移特征和生存分析*()
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2017年04期
页码:
443-447
栏目:
应用研究
出版日期:
2017-07-15

文章信息/Info

Title:
Features of initially presenting metastases and survival analysis in patients with stage Ⅳ lung adenocarcinoma
作者:
李 莎1)吴 静1)胡亚辉1)韩星敏2)#刘保平2)李彦鹏2)
1)郑州大学附属郑州中心医院核医学科 郑州 450007;
2)郑州大学第一附属医院核医学科 郑州 450052
Author(s):
LI Sha1)WU Jing1)HU Yahui1)HAN Xingmin2)LIU Baoping2)LI Yanpeng2)
1)Department of Nuclear Medicine,the Affiliated Zhengzhou Central Hospital, Zhengzhou University, Zhengzhou 450007;
2)Department of Nuclear Medicine, the First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052
关键词:
肺腺癌 表皮生长因子受体 转移 生存分析
Keywords:
lung adenocarcinoma epidermal growth factor receptor metastasis survival analysis
分类号:
R734.2
DOI:
10.13705/j.issn.1671-6825.2017.04.017
摘要:
目的:探讨初诊Ⅳ期肺腺癌患者转移的主要特征和临床预后。方法:回顾性收集160例经病理和全身成像证实的Ⅳ期肺腺癌患者的临床资料,应用Kaplan-Meier 方法计算生存率,采用Cox 多因素回归对预后因素进行分析。结果:肺腺癌最常见的转移部位为胸部淋巴结134例(83.8%)、肺/肺淋巴管101例(63.1%)和胸膜/心包71例(44.4%)。160例肺腺癌中位生存期为18.0个月,1、2、3 a生存率分别为64.6%、30.8%、20.1%。单因素生存分析结果显示,患者年龄、性别、肿瘤分化程度、胸部淋巴结有无转移、胸膜/心包有无转移、腹部/盆腔有无转移、颈部/腋窝淋巴结有无转移和有无用TKI治疗对生存率有影响(P<0.05)。Cox回归分析结果显示,影响Ⅳ期肺腺癌患者生存率的危险因素有肿瘤分化程度(OR=2.648,95%CI=1.689~4.150)、颈部/腋窝淋巴结是否转移(OR=2.517,95%CI=1.358~4.664)、腹部/盆腔是否转移(OR=2.005,95%CI=1.203~3.342)、胸部淋巴结是否转移(OR=1.972,95%CI=1.067~3.645)、是否用TKI治疗(OR=1.694,95%CI=1.073~2.675)、胸膜/心包是否转移(OR=1.664,95%CI=1.050~2.637)。结论:Ⅳ期肺腺癌有独特的转移特征; 肿瘤分化程度,颈部/腋窝淋巴结、腹部/盆腔、胸部淋巴结、胸膜/心包是否转移,是否使用TKI治疗,可作为Ⅳ期肺腺癌患者预后的评价指标。
Abstract:
Aim: To investigate the features of metastasis and clinical prognosis of patients with stage Ⅳ lung adenocarcinoma.Methods: The clinical data of 160 stage Ⅳ lung adenocarcinoma patients who were confirmed by pathology and whole body imaging were retrospectively reviewed. The survival rate was evaluated by Kaplan-Meier method. The prognosis were analyzed by Cox multivariate regression.Results: The most common sites of metastasis of lung adenocarcinoma were thoracic lymph nodes(83.8%), pulmonary/pulmonary lymphatics(63.1%), and pleural/pericardial(44.4%). The median survival time was 18.0 months. One-, two- and three-year survival rates were 64.6%, 30.8%, and 20.1%, respectively.Univariate analysis showed that age, gender, tumor differentiation, thoracic lymph node metastasis status, pleural/pericardial metastasis, abdominal/pelvic metastasis, neck/axilla lymph node metastasis and TKI treatment had significant association with survival rate(P<0.05). Cox regression analysis showed that tumor differentiation(OR=2.648, 95%CI=1.689-4.150), neck/axilla lymph node metastasis(OR=2.517, 95%CI=1.358-4.664), abdomen/pelvis metastasis(OR=2.005, 95%CI=1.203-3.342), thoracic lymph node metastasis status(OR=1.972, 95%CI=1.067-3.645), TKI treatment(OR=1.694, 95%CI=1.073-2.675), pleural/pericardial metastasis(OR=1.664, 95%CI=1.050-2.637)were risk factors of prognosis of lung adenocarcinoma.Conclusion: Stage Ⅳ lung adenocarcinoma has a unique characteristic of metastasis. Tumor differentiation, neck/axilla lymph node metastasis, abdomen/pelvis metastasis, thoracic lymph node metastasis status, TKI treatment, pleural/pericardial metastasis status of stage Ⅳ lung adenocarcinoma may be prognostic indicators.

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备注/Memo

备注/Memo:
*国家自然科学基金资助项目 U1404818
#通信作者,男,1965年12月生,硕士,主任医师,教授,研究方向:肿瘤核医学,E-mail:XMhan@zzu.edu.cn
更新日期/Last Update: 2017-07-20