老年肺癌术后化疗患者3年预后评估及影响因素分析

Evaluation of 3-year prognosis and analysis of its influencing factors in elderly patients with lung cancer undergoing radical surgery and postoperative chemotherapy

中文关键词: 老年  肺癌  根治性手术  术后辅助化疗  预后  影响因素

英文关键词: elderly  lung cancer  radical resection  postoperative adjuvant chemotherapy  prognosis  influencing factor

中文摘要:

      目的 分析老年肺癌根治性术后化疗患者 3 年预后情况,并探讨其影响因素.方法 收集 2019 年 9 月—2020 年9 月民航总医院行肺癌根治术治疗的98 例老年肺癌患者为研究对象;所有患者术后随访3 年,记录患者随访期内生存情况;收集患者的临床资料,应用多因素Cox回归模型分析影响老年肺癌术后化疗患者 3 年预后的风险因素.结果 98 例肺癌患者中共有51 例(52.04%)出现复发、转移,其中局部复发18 例,远处转移33 例,以肺、脑、骨及胸膜转移为主;中位无病生存期(DFS)为35.3 个月,3 年无病生存率为47.96%(47/98).单因素分析结果显示,术后 3 年无病生存率与患者肿瘤组织学类型、病理分期、分化程度、术后化疗周期,以及复发时血清癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、鳞癌抗原(SCC)、糖类抗原125(CA125)、细胞角质蛋白19 片段(CYFRA21-1)水平有关(P＜0.05).多因素Cox回归分析结果显示,病理分期Ⅱ/Ⅲ期、化疗周期＜3 和复发时CEA水平≥5.0 mg/dL、NSE≥17.0 ng/mL、SCC≥1.5 μg/L、CA125≥35 U/mL、CYFRA21-1≥3.5 ng/mL 是老年肺癌术后化疗患者 3 年预后的风险因素(P＜0.05).结论 老年肺癌根治性术后化疗患者3 年无病生存率为47.96%,病理分期Ⅱ/Ⅲ期、化疗周期＜3 和复发时CEA水平≥5.0 mg/dL、NSE≥17.0 ng/mL、SCC≥1.5 μg/L、CA125≥35 U/mL、CYFRA21-1≥3.5 ng/mL可能是老年肺癌术后化疗患者3 年预后的风险因素.

英文摘要:

      Objective To analyze the 3-year prognosis of elderly lung cancer patients undergoing radical surgery and postoperative chemotherapy and explore its influencing factors.Methods A total of 98 elderly patients with lung cancer who underwent radical resection of lung cancer in Civil Aviation General Hospital from September 2019 to September 2020 were en-rolled as the research subjects.All patients were followed up for 3 years after surgery and their survival was recorded during the follow-up period.Their clinical data were collected.Multivariate Cox regression model was used to analyze the risk factors af-fecting the 3-year prognosis of elderly patients with lung cancer after postoperative chemotherapy.Results Among 98 lung cancer patients,51 ones(52.04% )experienced recurrence and metastasis,including local recurrence in 18 ones and distant metastasis in 33 ones.The main metastasis sites were lung,brain,bone and pleura.The median disease-free survival(DFS)was35.3 months,and the3-year DFS rate was47.96% (47/98).The results of univariate analysis showed that the 3-year DFS rate after surgery was related to tumor histological type,pathological stage,degree of differentiation,postoperative chem-otherapy cycle,as well as the levels of serum carcinoembryonic antigen(CEA),neuron specific enolase(NSE),squamous cell carcinoma antigen(SCC),carbohydrate antigen 125(CA125),and cytokeratin 19 fragment(CYFRA21-1)at recurrence(P＜0.05).The results of multivariate Cox regression analysis showed that pathological stage Ⅱ/Ⅲ,chemotherapy cycle＜3,CEA≥5.0 mg/dL,NSE≥17.0 ng/mL,SCC≥1.5 μg/L,CA125≥35 U/mL,CYFRA21-1≥3.5 ng/mL at recurrence were risk factors for the 3-year prognosis of elderly lung cancer patients undergoing radical surgery and postoperative chemotherapy(P＜0.05).Conclusion The 3-year DFS rate is 47.96% in elderly patients with lung cancer undergoing radical surgery and postoperative chemotherapy.Pathological staging Ⅱ/Ⅲ,chemotherapy cycle＜3,CEA≥5.0 mg/dL,NSE≥17.0 ng/mL,SCC≥1.5 μg/L,CA125≥35 U/mL,CYFRA21-1≥3.5 ng/mL at recurrence may be risk factors for the 3-year prognosis of elderly lung cancer patients undergoing radical surgery and postoperative chemotherapy.