CAJ | 학술논문

目的：通过回顾性分析研究晚期非小细胞肺癌（NSCLC）患者初诊时和化疗后贫血的发生情况，探讨初诊时贫血和化疗后贫血对NSCLC化疗疗效及生存预后的影响。方法收集2003年5月~2010年11月汕头大学医学院附属肿瘤医院内科收治的不可手术切除的晚期184例NSCLC的病历资料。按初诊时血红蛋白（Hb）将患者分成贫血组和非贫血组。男性Hb＜120g/L，女性Hb＜l10g/L定义为贫血。两样本率的比较采用x2检验，生存分析采用Kaplan-Meier乘积法和log-rank检验，多因素分析采用COX逐步回归模型。结果184例患者中初诊时伴贫血31例（16.8%），随着化疗周期数的增加，贫血的发生率逐渐升高，第2周期及第4周期化疗后相应的贫血发生率分别62%（114/184），76.6%（111/145），P＜0.001。NSCLC 初诊时有无贫血对化疗疗效差别无统计学意义（P=0.235）,而无论是2周期还是4周期化疗后贫血都与化疗有效率显著相关（P＜0.001)。贫血组的中位生存期11个月，1年生存率41.9%，无贫血组12个月，1年生存率53.6%，差异无统计学意义（P=0.921）；COX 模型回归显示PS评分（P=0.004）和基础白蛋白水平（P=0.001）是晚期NSCLC 的独立预后因素。结论晚期NSCLC患者无论是治疗前还是治疗后贫血的发生率均高，需引起临床医生的重视，初诊时贫血对化疗效果及预后虽然没有明显影响，但化疗后贫血与化疗疗效显著相关。而基础白蛋白水平和PS评分是晚期NSCLC患者的独立预后因素。
목적：통과회고성분석연구만기비소세포폐암（NSCLC）환자초진시화화료후빈혈적발생정황，탐토초진시빈혈화화료후빈혈대NSCLC화료료효급생존예후적영향。방법수집2003년5월~2010년11월산두대학의학원부속종류의원내과수치적불가수술절제적만기184례NSCLC적병력자료。안초진시혈홍단백（Hb）장환자분성빈혈조화비빈혈조。남성Hb＜120g/L，녀성Hb＜l10g/L정의위빈혈。량양본솔적비교채용x2검험，생존분석채용Kaplan-Meier승적법화log-rank검험，다인소분석채용COX축보회귀모형。결과184례환자중초진시반빈혈31례（16.8%），수착화료주기수적증가，빈혈적발생솔축점승고，제2주기급제4주기화료후상응적빈혈발생솔분별62%（114/184），76.6%（111/145），P＜0.001。NSCLC 초진시유무빈혈대화료료효차별무통계학의의（P=0.235）,이무론시2주기환시4주기화료후빈혈도여화료유효솔현저상관（P＜0.001)。빈혈조적중위생존기11개월，1년생존솔41.9%，무빈혈조12개월，1년생존솔53.6%，차이무통계학의의（P=0.921）；COX 모형회귀현시PS평분（P=0.004）화기출백단백수평（P=0.001）시만기NSCLC 적독립예후인소。결론만기NSCLC환자무론시치료전환시치료후빈혈적발생솔균고，수인기림상의생적중시，초진시빈혈대화료효과급예후수연몰유명현영향，단화료후빈혈여화료료효현저상관。이기출백단백수평화PS평분시만기NSCLC환자적독립예후인소。
Objective To retrospectively analyze the diagnosis and the occurrence of anemia in advanced non-small cell lung cancer (Non-small cell lung cancer, NSCLC) after chemotherapy in patients, and investigate the impact of anemia and explore newly diagnosed anemia after chemotherapy for NSCLC chemotherapy and survival prognosis.Methods184 cases medical records with advanced unresectable of NSCLC admitted in Affiliated Tumor Hospital of Shantou University Medical from May 2003 to November 2010 were collected. When diagnosed by hemoglobin ( Hb) patients were divided into anemia group and non-anemic group. Men Hb<120g/L, women Hb<l10g/ L was defined as anemia. Were compared using two sample rate ofx2 test, using the Kaplan-Meier survival analysis and log-rank product method test, multivariate analysis using COX regression model. Results184 cases of anemia with 31 cases newly diagnosed (16.8%), with the increase in the number of cycles of chemotherapy, the incidence of anemia increased gradually after the second cycle and 4 cycles of chemotherapy, respectively, corresponding to 62% incidence of anemia (114/184), 76.6% (111/145),P<0.001. When newly diagnosed NSCLC chemotherapy with or without anemia on the difference was not statistically significant(P=0.235),but whether it was two cycles or after 4 cycles of chemotherapy were significantly associated with anemia and chemotherapy effective rate (P<0.001). The median survival of 11 months anemia group, 1-year survival rate was 41.9%, non-anemic group 12 months, 1-year survival rate was 53.6%,the difference was not statistically significant(P=0.921); COX regression display PS score (P=0.004) and basic albumin levels(P=0.001) were independent prognostic factors for advanced NSCLC.ConclusionAdvanced NSCLC treatment either before or after treatment, high rates of anemia, need to arouse the attention of clinicians, anemia at diagnosis Although chemotherapy and prognosis of no significant impact, but anemia after chemotherapy was significantly associated with chemotherapy. The foundation albumin levels and PS score is an independent prognostic factor in patients with advanced NSCLC.