摘要
背景研究表明,青中年和老年癌症患者临床病理特征及预后存在差异。近年来非小细胞肺癌(NSCLC发病年龄呈年轻化趋势,故明确NSCLC患者年龄与临床病理特征、预后的关系或有助于指导临床治疗。目的探讨NSCLC患者年龄与临床病理特征、预后的关系。方法选取2014年1月—2017年10月荆州市胸科医院收治的207例NSCLC患者作为研究对象,根据年龄分为青中年组(<60岁,n=82)和老年组(≥60岁,n=125)。比较两组患者一般资料、临床病理特征、治疗方式,NSCLC患者年龄与TNM分期、病理类型、远处转移及肿瘤分化程度的关系分析采用多因素Logistic回归分析;绘制生存曲线,比较两组患者1年、3年累积生存率,NSCLC患者年龄与3年生存状况的关系分析采用多元Cox回归分析。结果青中年组中有肺癌家族史、TNM分期为Ⅲ~Ⅳ期、病理类型为腺癌、肿瘤分化程度为高分化者所占比例高于老年组,病理类型为鳞癌者所占比例低于老年组(P<0.05)。多因素Logistic回归分析结果显示,年龄是NSCLC患者TNM分期、病理类型、肿瘤分化程度的独立影响因素(P<0.05)。青中年组患者手术治疗率高于老年组,姑息治疗率低于老年组(P<0.05)。多元Cox回归分析结果显示,吸烟史〔HR=1.680,95%CI(1.107,2.551)〕、TNM分期为Ⅲ~Ⅳ期〔HR=1.775,95%CI(1.142,2.759)〕、远处转移〔HR=1.859,95%CI(1.068,3.237)〕及肿瘤分化程度为高分化〔HR=1.670,95%CI(1.109,2.516)〕是NSCLC患者3年生存状况的危险因素(P<0.05)。结论与老年NSCLC患者相比,青中年NSCLC患者中有肺癌家族史、TNM分期为Ⅲ~Ⅳ期、病理类型为腺癌、肿瘤分化程度为高分化者占比更高,更倾向于采用手术治疗;年龄是NSCLC患者TNM分期、病理类型、肿瘤分化程度的影响因素,但其对NSCLC患者3年生存状况无明显影响。
Background Studies have shown that there are differences in clinicopathological characteristics and prognosis between young and middle-aged cancer patients and elderly cancer patients.In recent years,the incidence of nonsmall cell lung cancer(NSCLC)tends to be younger.Therefore,clarifying the relationship between age and clinicopathological characteristics,prognosis of NSCLC patients may be helpful to guide clinical treatment.Objective To investigate the relationship between age and clinicopathological characteristics,prognosis in patients with NSCLC.Methods Two hundred and seven NSCLC patients who were treated in Jingzhou Chest Hospital from January 2014 to October 2017 were selected as the study subjects,and they were divided into youth and middle-aged group(<60 years old,n=82)and elderly group(≥60 years old,n=125)according to the age.The general information,clinicopathological characteristics and treatment methods were compared between the two groups.The relationship between age and TNM stage,pathological types,metastasis,differentiation of the tumor was analyzed by multivariate Logistic regression analysis in patients with NSCLC.The survival curve was drawn,and the cumulative survival rate of 1 year and 3 years were compared between the two groups.The relationship between age and 3 years survival of NSCLC patients was analyzed by multivariate Cox regression analysis.Results The proportions of cases with family history of lung cancer,TNM stage atⅢ-Ⅳ,adenocarcinoma of pathological type and high differentiation of the tumor in young and middle-aged group were higher than those in elderly group,the proportion of cases with squamous cell carcinoma of pathological type in young and middle-aged group was lower than that in elderly group(P<0.05).Multivariate Logistic regression analysis showed that age was independent influencing factor of TNM stage,pathological types and differentiation of the tumor in patients with NSCLC(P<0.05).The operation treatment rate of the young and middle-aged group was higher than that of the elderly group,and the palliative treatment rate was lower than that of the elderly group(P<0.05).Multivariate Cox regression analysis showed that smoking history〔HR=1.680,95%CI(1.107,2.551)〕,TNM stage atⅢandⅣ〔HR=1.775,95%CI(1.142,2.759)〕,metastasis〔HR=1.859,95%CI(1.068,3.237)〕and high differentiation of the tumor〔HR=1.670,95%CI(1.109,2.516)〕were risk factors for 3-year survival in patients with NSCLC(P<0.05).Conclusion Compared with elderly NSCLC patients,the proportions of cases with family history of lung cancer,TNM stage atⅢ-Ⅳ,adenocarcinoma of pathological type and high differentiation of the tumor in young and middle-aged group are higher,and are more likely to use surgical treatment;and age is the influencing factor of TNM stage,pathological types,differentiation of the tumor in patients with NSCLC.However,age has no significant effect on the 3-year survival of patients with NSCLC.
作者
杨维维
漆静
YANG Weiwei;QI Jing(Endoscopy Center,Jingzhou Chest Hospital,Jingzhou 434000,China;Xiantao Vocational College Medical School,Xiantao 433000,China)
出处
《实用心脑肺血管病杂志》
2021年第6期63-67,共5页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
湖北省职业技术教育研究重点课题(ZJGA201847)。
关键词
非小细胞肺癌
年龄
临床病理特征
预后
关系
Non-small cell lung cancer
Age
Clinicopathological characteristic
Prognosis
Relationship
