摘要
目的探索非转移性非小细胞肺癌(NSCLC)患者慢性阻塞性肺疾病(慢阻肺)相关死亡率及其危险因素。方法本研究为回顾性队列研究,纳入美国“监测、流行病学和最终结果”(SEER)数据库中2010—2019年间确诊的非转移性NSCLC患者,其中队列1入组18~<80岁患者89621例,用于计算慢阻肺相关死亡率;队列2在队列1基础上纳入60~<80岁患者71949例,通过竞争风险模型分析慢阻肺相关死亡的危险因素。结果非转移性NSCLC患者慢阻肺相关死亡率为2.86%,慢阻肺相关死亡率随年龄增长而升高,60~<80岁患者的慢阻肺相关死亡率为3.24%,占全年龄段慢阻肺相关死亡人数的90.9%。在单因素竞争风险模型中,高龄、男性、白种人、鳞癌、淋巴结转移阴性、未行手术治疗、放疗、未行化疗、低收入人群、单身是发生慢阻肺相关死亡的危险因素。多因素竞争风险模型显示高龄(70~74岁:HR=1.24,95%CI:1.09~1.42;75~79岁:HR=1.23,95%CI:1.07~1.41)、鳞癌(HR=1.75,95%CI:1.60~1.92)、放疗(HR=1.58,95%CI:1.41~1.70)是慢阻肺相关死亡的独立危险因素(均P<0.05)。结论非转移性NSCLC患者慢阻肺相关死亡率较高,高龄、鳞癌和放疗是其主要危险因素。
Objective To explore the mortality and risk factors for chronic obstructive pulmonary disease(COPD)-related mortality in patients with non-metastatic non-small cell lung cancer(NSCLC).Methods This retrospective cohort study included patients aged 18-80 diagnosed with NSCLC between 2010 and 2019 from the Surveillance,Epidemiology and End Results(SEER)database.Cohort 1 enrolled 89621 cases of non-metastatic NSCLC to calculate COPD-related mortality;Cohort 2 included 71949 elderly patients with non-metastatic NSCLC to investigate the risk factors of COPD-related mortality in non-metastatic NSCLC patients using a competing risks model.Results COPD-related mortality rate was 2.86%among non-metastatic NSCLC patients.COPD-related mortality rate increased with age,with a COPD-related mortality rate of 3.24%in patients aged 60 to<80 years,accounting for 90.9%of COPD related deaths in the whole age group with non-metastatic NSCLC.In the univariate competing risks model,advanced age,male,white race,squamous cell carcinoma,negative lymph node metastasis,no surgical treatment,radiotherapy,no chemotherapy,low-income population and single were identified as risk factors for COPD-related mortality.The multivariate competing risks model revealed that advanced age(70-74 years old:HR=1.24,95%CI:1.09-1.42;75-79 years old:HR=1.23,95%CI:1.07-1.41),squamous cell carcinoma(HR=1.75,95%CI:1.60-1.92),radiotherapy(HR=1.58,95%CI:1.41-1.70)were independent risk factors for COPD-related mortality(all P<0.05).Conclusions COPD-related mortality rate is high in non-metastatic NSCLC patients.Aged over 70 years old,squamous cell carcinoma and radiotherapy are risk factors for COPD-related death.
作者
贾国华
李祥攀
Jia Guohua;Li Xiangpan(Cancer Center,Renmin Hospital of Wuhan University,Wuhan 430060,China;Department of Radiotherapy,Renmin Hospital of Wuhan University,Wuhan 430060,China)
出处
《中华健康管理学杂志》
CAS
CSCD
北大核心
2024年第10期754-760,共7页
Chinese Journal of Health Management
基金
湖北省自然科学基金(2023AFB218)
中央高校基本科研业务费专项资金(2042022kf1109)。
关键词
肺疾病
慢性阻塞性
肺肿瘤
癌
非小细胞肺
危险因素
死亡率
非肿瘤死亡
生存
Pulmonary disease,chronic obstructive
Lung neoplasms
Carcinoma,non-small-cell lung
Risk factors
Mortality
Non-cancer related death
Survival
