肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2012年
1期
24-27
,共4页
曹霞%汪安兰%杨锫%袁媛%吴胜其%罗荣喜
曹霞%汪安蘭%楊锫%袁媛%吳勝其%囉榮喜
조하%왕안란%양부%원원%오성기%라영희
癌,非小细胞肺%肿瘤转移%危险因素
癌,非小細胞肺%腫瘤轉移%危險因素
암,비소세포폐%종류전이%위험인소
Carcinoma,non-small-cell lung%Neoplasm metastases%Risk factors
目的 探索并选定局部晚期非小细胞肺癌(LA-NSCLC)预防性脑照射目标人群.方法 回顾性分析2006年6月至2010年10月收治的114例LA-NSCLC患者资料,选择其中相关病例分析脑转移高危因素及相关特点.结果 2年脑转移率31.58％(36/114),脑转移首发的发生率为20.18％(23/114).孤立脑转移的发生率为9.65％(11/114).二值Logistic回归分析进入方程的变量为病理类型( OR=5.892)和治疗方式(OR=2.888),非鳞状细胞癌和单一治疗方式的患者脑转移率高(P＜0.01),模型拟合度好(P＞0.05).预测脑转移的总正确率为67.7％.脑转移或死亡病例乳酸脱氢酶增高率(17.54％)较无脑转移并生存病例(0)高(P＜0.01),同时显示纵隔淋巴结转移组数与个数呈正相关(r=0.716,P＜0.01),腺癌较鳞状细胞癌脑转移或死亡率高(P＜0.01),且有更多的纵隔淋巴结转移(P＜0.05).鳞状细胞癌及腺癌肿瘤最大直径均数分别为5.8 cm和3.9 cm(P＜ 0.01).结论 LA-NSCLC患者单一治疗方式脑转移发生率高.原发肿瘤大、乳酸脱氢酶高、非鳞状细胞癌、多站及多个纵隔淋巴结转移可作为脑转移相关危险因素进行预防性脑照射研究.
目的 探索併選定跼部晚期非小細胞肺癌(LA-NSCLC)預防性腦照射目標人群.方法 迴顧性分析2006年6月至2010年10月收治的114例LA-NSCLC患者資料,選擇其中相關病例分析腦轉移高危因素及相關特點.結果 2年腦轉移率31.58％(36/114),腦轉移首髮的髮生率為20.18％(23/114).孤立腦轉移的髮生率為9.65％(11/114).二值Logistic迴歸分析進入方程的變量為病理類型( OR=5.892)和治療方式(OR=2.888),非鱗狀細胞癌和單一治療方式的患者腦轉移率高(P＜0.01),模型擬閤度好(P＞0.05).預測腦轉移的總正確率為67.7％.腦轉移或死亡病例乳痠脫氫酶增高率(17.54％)較無腦轉移併生存病例(0)高(P＜0.01),同時顯示縱隔淋巴結轉移組數與箇數呈正相關(r=0.716,P＜0.01),腺癌較鱗狀細胞癌腦轉移或死亡率高(P＜0.01),且有更多的縱隔淋巴結轉移(P＜0.05).鱗狀細胞癌及腺癌腫瘤最大直徑均數分彆為5.8 cm和3.9 cm(P＜ 0.01).結論 LA-NSCLC患者單一治療方式腦轉移髮生率高.原髮腫瘤大、乳痠脫氫酶高、非鱗狀細胞癌、多站及多箇縱隔淋巴結轉移可作為腦轉移相關危險因素進行預防性腦照射研究.
목적 탐색병선정국부만기비소세포폐암(LA-NSCLC)예방성뇌조사목표인군.방법 회고성분석2006년6월지2010년10월수치적114례LA-NSCLC환자자료,선택기중상관병례분석뇌전이고위인소급상관특점.결과 2년뇌전이솔31.58％(36/114),뇌전이수발적발생솔위20.18％(23/114).고립뇌전이적발생솔위9.65％(11/114).이치Logistic회귀분석진입방정적변량위병리류형( OR=5.892)화치료방식(OR=2.888),비린상세포암화단일치료방식적환자뇌전이솔고(P＜0.01),모형의합도호(P＞0.05).예측뇌전이적총정학솔위67.7％.뇌전이혹사망병례유산탈경매증고솔(17.54％)교무뇌전이병생존병례(0)고(P＜0.01),동시현시종격림파결전이조수여개수정정상관(r=0.716,P＜0.01),선암교린상세포암뇌전이혹사망솔고(P＜0.01),차유경다적종격림파결전이(P＜0.05).린상세포암급선암종류최대직경균수분별위5.8 cm화3.9 cm(P＜ 0.01).결론 LA-NSCLC환자단일치료방식뇌전이발생솔고.원발종류대、유산탈경매고、비린상세포암、다참급다개종격림파결전이가작위뇌전이상관위험인소진행예방성뇌조사연구.
Objective To evaluate the prognostic factors in locally advanced non-small-cell lung cancer (LA-NSCLC) for selectively carrying out prophylactic cranial irradiation (PCI).Methods 114 patients with LA-NSCLC between Jun 2006 and Oct 2010 were retrospectively analyzed. Related risk factors and features about brain metastases were analyzed.Results The 2-year incidence rate of brain metastases was 31.58 ％ (36/114),the first brain metastases was 20.18 ％ (23/114),and sole brain metastases was 9.65 ％(11/114),respectively.Variables involved in the equation of binary logistic regression analysis were pathology (OR =5.892) and treatment mode(OR =2.888).The incidence rate of brain metastases in patients of non-squamous carcinoma and single treatment mode was higher than others (P ＜ 0.01) Model fitting is better (P ＞ 0.05).Overall accuracy rate of predicting brain metastases is 67.7 ％.The increased rate of lactate dehydrogenase in the patients with brain metastases or death was 17.54 ％, which was higher than that in the survival patients without brain metastases (P ＜ 0.01).At the same time,the station number and the number of mediastinal lymph node metastases were positively correlated (r =0.716, P ＜ 0.01).The incidence rate of brain metastases or mortality rate was higher in the adenocarcinoma cases than that in the squamous carcinoma cases (P ＜ 0.01,P ＜ 0.05),with more frequent occurrence of mediastinal metastases.The mean diameter of squamous carcinoma and adenocarcinoma were 5.8 cm and 3.9 cm, respectively (P ＜ 0.01).Conclusions The incidence rate of brain metastases was higher in patients with single treatment.Large primary tumors, high lactate dehydrogenase, non-squamous carcinoma, multiple stations, and multiple mediastinal lymph nodes metastases can be regarded as risk factors of brain metastases to perform PCI.
