影响非小细胞肺癌无进展生存期相关因素的分析

发布时间：2018-03-15 07:16

  本文选题：I~III期非小细胞肺癌　切入点：预后相关因素　出处：《吉林大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:回顾性分析312例I~III期NSCLC患者临床特征,并初步讨论影响I~III期NSCLS患者无进展生存期的有关因素,以有助于实现非小细胞肺癌的三级预防,控制疾病进展。对象和方法:通过吉林大学第一医院病案检索系统收集2012年1月1日至2015年1月1日在吉林大学白求恩第一医院就诊并明确诊断的312例I~III期非小细胞肺癌患者的临床资料,记录内容包括:非小细胞肺癌患者性别、年龄、文化程度、吸烟指数,居住地、体重指数、TNM分期、病理类型、首诊主诉、既往呼吸系统病史、肿瘤标志物癌胚抗原(carcino-embryonic antigen CEA)及细胞角蛋白19片段(Cytokerantin-19-fragment CYFRA21-1)、碱性磷酸酶(alkaline phosphatase ALP)、卡氏功能状态(Karnofsky Performance Status KPS)评分及白蛋白水平等,采用SPSS18.0统计软件分析影响NSCLS无进展生存时间的相关因素。结果:1、I~III期NSCLS患者总的1、2年无进展生存率分别为51.6%和39.1%。中位无进展生存时间为14个月。2、单因素分析中年龄、文化程度、居住地、吸烟指数、BMI、TNM分期、病理类型、首诊主诉、既往呼吸系统病史、肿瘤标志物CEA及CYFRA21-1、碱性磷酸酶及KPS评分与I~III期NSCLS患者无进展生存期有关。尚未发现性别、肿瘤家族史及白蛋白水平等与I~III期NSCLS患者无进展生存期相关。3、多因素分析显示居住地、BMI、TNM分期、病理类型、治疗前KPS评分是影响I~III期NSCLS患者预后的独立因素。结论:1、居住地、BMI、TNM分期、病理类型、治疗前KPS评分是影响I~III期NSCLS患者无进展生存期(progression-freesurvival PFS)长短的独立预后因素。2、居住地为农村,BMI指数≥18.5,TNM分期处于I~II期,病理类型为鳞癌以及KPS评分≥90分的I~III期NSCLS患者预后较好,无进展生存期较长。3、年龄,文化程度,吸烟指数,首诊主诉,既往呼吸系统病史,肿瘤标志物CEA及CYFRA21-1,碱性磷酸酶与NSCLC的PFS长短未见统计学关联。
[Abstract]:Objective: to retrospectively analyze the clinical features of 312 patients with stage III NSCLC, and to discuss the factors affecting the progressive survival of patients with stage I stage III NSCLS, so as to help realize the tertiary prevention of non-small cell lung cancer (NSCLC). Progress of disease control. Objects and methods: 312 cases of stage III Icara were collected from January 1st 2012 to January 1st 2015 in Bai Qiuen first Hospital, Jilin University, through the Medical record Retrieval system of the first Hospital of Jilin University. Clinical data of patients with cell lung cancer, The records included: sex, age, education, smoking index, residence, body mass index (BMI), TNM staging, pathological type, primary complaint, previous respiratory history, Tumor marker carcino-embryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1), alkaline phosphatase (ALP), Karnofsky Performance Status (KPSs) and albumin level, and so on. Results the overall 1 and 2 year progression free survival rates were 51.6% and 39.1 in patients with stage III NSCLS of NSCLS by using SPSS18.0 software. The median survival time of progression free patients was 14 months. The median survival time was 14 months. The median age and education level in univariate analysis were 1 and 2 years, respectively. Residence, smoking index, BMI-TNM staging, pathological type, primary complaint, previous respiratory history, tumor markers CEA and CYFRA21-1, alkaline phosphatase and KPS score were associated with progressive survival in patients with stage III NSCLS. No sex was found. Familial history and albumin levels were associated with progressive survival in patients with stage III NSCLS. Multivariate analysis showed that the location of BMI-TNM staging, pathological type, and so on. Before treatment, KPS score was an independent factor for the prognosis of patients with NSCLS in stage III. Conclusion: 1. Before treatment, KPS score was an independent prognostic factor of progressive progressive survival (PFS) in patients with NSCLS in stage III. The patients living in rural areas with KPS index 鈮，

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