老年非小细胞肺癌合并慢性阻塞性肺病患者的临床特征
发布时间：2018-11-29 13:31
【摘要】：目的探讨老年非小细胞肺癌(NSCLC)合并慢性阻塞性肺疾病(COPD)患者的临床特点、治疗策略及预后,为临床诊治状况提供合理建议。方法回顾性收集2000年1月~2015年6月之间,在解放军总医院老年病区就诊的年龄在60以上,新诊断NSCLC并COPD的患者的临床资料。主要收集的临床数据包括:吸烟习惯,肺功能检测,起始治疗策略,TNM分期,主诉症状,合并疾病和实验室化验等。应用COX比例风险回归模型进行多因素分析。结果回顾性总结200例NSCLC患者,其中107例(53.5%)通过吸入支气管扩张剂并通过肺功能测试,确诊合并COPD,纳入本研究。全组患者中位生存时间45.8月,1、3、5、10年生存率分别为80.4%、55.4%、41.0%、20.0%。分层分析显示COPD Gold分级为1度和2度患者的总生存时间显著长于Gold 3度和4度的患者(Gold 1 vs.3/4∶51.7月vs 16.9月,P=0.020;Gold 2 vs 3/4∶43.1月vs 16.9月,P=0.043)。利用Cox比例风险回归模型进行单因素和多因素分析显示,年龄增大,Gold分级越重,治疗3个月内Gold分级未改善,TNM分期越晚(Ⅲ和Ⅳ期),病理类型为鳞癌,起始治疗非手术,以及主诉症状为咳嗽和较高的血清CEA值是影响生存预后的独立危险因子。结论研究发现影响本组老年NSCLC-COPD患者生存预后的因素有很多,其中COPD Gold分级越重,治疗3个月内Gold分级未改善是其中的独立危险因子。
[Abstract]:Objective to investigate the clinical characteristics, treatment strategy and prognosis of elderly patients with (NSCLC) complicated with chronic obstructive pulmonary disease (COPD), and to provide reasonable advice for clinical diagnosis and treatment. Methods from January 2000 to June 2015, the clinical data of patients who were over 60 years old and newly diagnosed with NSCLC and COPD in the geriatric area of PLA General Hospital were collected retrospectively. The main clinical data collected include: smoking habit, pulmonary function test, initial treatment strategy, TNM staging, main complaint symptoms, combined diseases and laboratory tests. COX proportional risk regression model was applied to multivariate analysis. Results among the 200 NSCLC patients, 107 (53.5%) were diagnosed by bronchiectasis and pulmonary function test. The median survival time of the whole group was 45.8 months, and the 10-year survival rate was 80.4 and 55.45.45.40, respectively. Stratified analysis showed that the total survival time of patients with COPD Gold grade 1 and 2 was significantly longer than that of patients with 3 and 4 degrees of Gold (Gold 1 vs.3/4:51.7 month vs 16.9 months, Gold 0.020 months); Gold 2 vs 3: 4: 43.1 vs 16.9, vs 0.043. Univariate and multivariate analysis using Cox proportional risk regression model showed that the older the age, the more severe the Gold grade was, and the later the TNM stage (鈪，
本文编号：2365127
[Abstract]:Objective to investigate the clinical characteristics, treatment strategy and prognosis of elderly patients with (NSCLC) complicated with chronic obstructive pulmonary disease (COPD), and to provide reasonable advice for clinical diagnosis and treatment. Methods from January 2000 to June 2015, the clinical data of patients who were over 60 years old and newly diagnosed with NSCLC and COPD in the geriatric area of PLA General Hospital were collected retrospectively. The main clinical data collected include: smoking habit, pulmonary function test, initial treatment strategy, TNM staging, main complaint symptoms, combined diseases and laboratory tests. COX proportional risk regression model was applied to multivariate analysis. Results among the 200 NSCLC patients, 107 (53.5%) were diagnosed by bronchiectasis and pulmonary function test. The median survival time of the whole group was 45.8 months, and the 10-year survival rate was 80.4 and 55.45.45.40, respectively. Stratified analysis showed that the total survival time of patients with COPD Gold grade 1 and 2 was significantly longer than that of patients with 3 and 4 degrees of Gold (Gold 1 vs.3/4:51.7 month vs 16.9 months, Gold 0.020 months); Gold 2 vs 3: 4: 43.1 vs 16.9, vs 0.043. Univariate and multivariate analysis using Cox proportional risk regression model showed that the older the age, the more severe the Gold grade was, and the later the TNM stage (鈪，
本文编号：2365127
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