肌少症对早期非小细胞肺癌术后患者远期预后的影响

发布时间：2018-04-18 19:10

  本文选题：肌少症 + 非小细胞肺癌　； 参考：《山东医药》2017年46期

【摘要】：目的探讨肌少症(SAR)对早期非小细胞肺癌(NSCLC)患者术后远期预后的影响。方法选择2011年1月~2014年12月行手术治疗的早期NSCLC患者212例,根据SAR诊断标准诊断是否存在SAR。记录并比较有、无SAR患者的临床病理资料,包括性别、年龄、BMI、合并症、吸烟史,术前血清癌胚抗原(CEA)、C反应蛋白(CRP)、白蛋白水平、手术相关情况、病理情况、术后放化疗情况。对所有患者进行长期随访,时间截止2016年12月31日,起点事件为手术,终点事件为死亡(全死因),记录患者随访期间的死亡、复发情况。采用Kaplan-Meier法估算生存率,采用log-rank检验比较生存率曲线差异,采用多变量Cox比例风险回归分析死亡和复发的影响因素。结果共诊断SAR 92例,占全部患者的43.4%(92/212)。与无SAR患者相比,SAR患者中女性比例较高、年龄较大、BMI和术前血清白蛋白水平较低、术前血清CRP水平较高(P0.05或0.01)。随访时间42(6~69)个月,无SAR患者的生存时间长于SAR患者(χ2=4.040,P=0.044)。多因素分析显示,年龄68岁、合并心血管疾病、病理分期Ⅱ期、高中分化程度和SAR均为死亡的危险因素(P均0.05)。无SAR患者的无复发生存时间长于SAR患者(χ2=4.703,P=0.030)。多因素分析显示,血管浸润、病理分期Ⅱ期、高中分化程度、放化疗和SAR均为复发的危险因素(P均0.05)。结论存在SAR时可明显缩短NSCLC患者术后的生存时间及无复发时间,是导致NSCLC患者术后死亡及复发的危险因素。
[Abstract]:Objective to investigate the long-term prognosis of patients with early non-small cell lung cancer (NSCLC).Methods 212 early NSCLC patients who underwent surgical treatment from January 2011 to December 2014 were selected and diagnosed according to the diagnostic criteria of SAR.The clinicopathological data of patients without SAR were recorded and compared, including sex, age, complication, smoking history, preoperative serum carcinoembryonic antigen (CEA) CEA C reactive protein (CRP), albumin level, surgical status, pathology, postoperative radiotherapy and chemotherapy.All patients were followed up for a long period of time, until December 31, 2016, the starting event was surgery, and the end event was death (all cause of death, record the death and recurrence of the patient during the follow-up period).Kaplan-Meier method was used to estimate the survival rate, log-rank test was used to compare the difference of survival curve, and multivariate Cox proportional risk regression analysis was used to analyze the influencing factors of death and recurrence.Results 92 cases of SAR were diagnosed, accounting for 43.4% of all patients.Compared with the patients without SAR, the proportion of females was higher, the serum albumin levels and serum CRP levels were lower in older women than those in patients without SAR, and the preoperative CRP levels were higher (P0.05 or 0.01).The survival time of the patients without SAR was longer than that of the patients with SAR (蠂 2 4.040 P < 0.044).Multivariate analysis showed that age 68 years old, complicated with cardiovascular disease, pathological stage 鈪，

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