摘要
目的分析晚期非小细胞肺癌(NSCLC)肿瘤生长速率(TGR)与临床病理特征及预后的相关性。方法纳入458例诊断时无法行根治性手术切除且经病理学证实的局部晚期或转移性NSCLC患者。回顾性收集相关临床病理参数,测量基线及第1次疗效评价时靶病灶最大直径总和,利用公式计算TGR,分析TGR与临床病理特征的关系,并应用Kaplan-Meier法分析TGR与无进展生存期(PFS)及总生存期(OS)的关系。利用COX风险比例回归模型进行单因素及多因素分析,明确TGR高低对预后的影响。结果高TGR多见于年龄≥60岁(P=0.038)、表皮生长因子受体(EGFR)野生型(P=0.013)、一线首选化疗(P=0.002)的患者。生存分析中,低TGR组中位PFS为8.7个月,高TGR组为4.2个月(P <0.001);低TGR组中位OS为24.6个月,高TGR组为16.4个月(P <0.001);低TGR组的中位PFS及OS明显优于高TGR组。结论 TGR在晚期NSCLC中与年龄、EGFR基因状态及一线治疗方案相关,且具有良好的预后预测价值,高TGR较低TGR人群生存期短,预后差。高TGR可作为影响PFS及OS的独立危险因素。
Objective To analyze the relationship between tumor growth rate(TGR) and clinicopathological features and prognosis in advanced non-small cell lung cancer(NSCLC). Methods A total of 458 patients with advanced NSCLC who never received radiotherapy or underwent surgery were selected. The clinicopathological features were collected retrospectively,and the sum of the maximum diameter of the target lesions at baseline and at first evaluation was measured. TGR was calculated using a formula. Progression-free survival(PFS) and overall survival(OS) were analyzed by the Kaplan-Meier survival curve. Univariate and multivariate analyses using COX risk proportional regression model were performed to indicate the effects of TGR on the prognosis. Results High TGR occurred frequently in elderly patients(P = 0.038),patients with wild-type epidermal growth factor receptor(EGFR)(P = 0.013),and patients receiving chemotherapy as the first-line treatment(P = 0.002). The median PFS was 8.7 months in the low TGR group and 4.2 months in the high TGR group(P <0.001). The median OS was 24.6 months in the low TGR group and 16.4 months in the high TGR group(P < 0.001). The PFS and OS in the low TGR group were significantly better than those in the high TGR group. Conclusion TGR correlated with age,EGFR gene,and first-line treatment,and it has a good prognostic value. The survival of patients with a high TGR is shorter than those with a low TGR. High TGR can be used as an independent risk factor for PFS and OS.
作者
孙翠翠
张斯萌
温倜
曲秀娟
刘云鹏
SUN Cuicui;ZHANG Simeng;WEN Ti;QU Xiujuan;LIU Yunpeng(Department of Medical Oncology,The First Hospital,China Medical University,Shenyang 110001,China)
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2019年第8期673-677,共5页
Journal of China Medical University
基金
国家自然科学基金（31770963）
辽宁省中央引导地方科技发展专项资金（2016007010）
“重大新药创制”科技重大专项（2017ZX09304025）
关键词
非小细胞肺癌
肿瘤生长速率
临床病理特征
预后
non-small cell lung cancer
tumor growth rate
clinicopathological feature
prognosis
