摘要
目的总结肺纤维化(PF)合并肺癌(LC)的临床特征,分析PF-LC患者的预后和影响因素。方法收集2008年1月至2014年3月期间住院PF患者中确诊LC患者53例,采用Cox回归模型分析多种临床因素对生存的影响;并通过Kaplan-Meier法计算中位生存期(MST)及总生存时间(OS),绘制生存曲线,比较不同临床因素对预后的作用。结果 53例PF-LC患者中,男性(n=48,90.6%)及吸烟(n=42,79.2%)患者多见,平均年龄(68.6±9.5)岁。通过Cox回归模型,对年龄、吸烟史、胸痛、Velcro啰音、PF类型、LC临床分期、LC治疗等因素分析显示,Velcro啰音(P=0.009)及临床分期(P=0.013)是PL-LC患者预后的独立影响因素。全组患者MST为6.0个月,1年、2年生存率分别为34.1%、22.0%。53例患者中,特发性PF-LC 42例(79.2%),继发性PF-LC 11例(20.8%);两组OS差异无统计学意义。不同LC病理类型患者中,NSCLC组(n=37)的OS较SCLC(n=6)及未分类组(10例)显著延长(P=0.035)。不同LC临床分期患者,Ⅰ期+Ⅱ期患者(n=13)较Ⅲ期+Ⅳ期患者(n=40)OS显著延长(P=0.002)。治疗上,针对LC治疗组(n=31)较未治疗组(n=22)MST及OS均显著延长(P<0.001);采取综合治疗方案组(n=11)较单一方案治疗组(n=20)的OS显著延长(P=0.036)。结论 Velcro啰音及LC临床分期是影响PF-LC患者预后的独立危险因素。治疗上,建议针对LC采用综合治疗方案,以延长患者的生存期。
Objective To analyze the clinical characteristics and survival of pulmonary fibrosis（ PF） patients complicated with lung cancer（ LC）（ PL-LC）. Methods Fifty-three patients with PF diagnosed as LC from January 2008 to March 2014 in Nanjing Drum Tower Hospital were included in this study. Univariate analysis and Cox regression analysis were used to detect the effects of clinical variables on survival. Kaplan-Meier method was used to calculate the median survival time（ MST） and overall survival（ OS）. Results Male patients（ n = 48,90. 6%） and patients with a history of smoking（ n = 42,79. 2%）were more easily suffered from PF-LC. The average age was 68. 6 ± 9. 5 years. Cox multivariate analysis revealed that Velcro crackles（ P = 0. 009） and clinical stage（ P = 0. 013） were the independent risk factors of survival in the patients with PF-LC. The MST of 53 patients was 6. 0 months. The survival rates of 1-year and 2-year were 34. 1% and 22. 0%,respectively. Forty-two（ 79. 2%） patients were idiopathic pulmonary fibrosis（ IPF） complicated with LC,and 11（ 20. 8%） patients were secondary pulmonary fibrosis（ SPF）complicated with LC. OS difference between two groups was not significant（ P = 0. 610）. OS of NSCLC group（ n = 37） was significantly prolonged than that of SCLC group（ n = 6） and unclassified pathological pattern group（ n = 10）（ P = 0. 035）. OS of Ⅰ and Ⅱstage patients（ n = 13） was significantly longer than that of Ⅲ and Ⅳ stage patients（ n = 40）（ P = 0. 002）. MST and OS of patients with LC treated（ n = 31）were significantly better than those of untreated patients（ n = 22）（ P〈 0. 001） and OS of patients treated by comprehensive therapy（ n = 11） was significantly prolonged than that of patients treated by mono-therapy（ n = 20）（ P = 0. 036）. Conclusions Velcro crackles and clinical stages are the independent risk factors of prognosis in PF-LC patients. It is beneficial to survival if the PF patients wit
出处
《中国呼吸与危重监护杂志》
CAS
北大核心
2016年第3期216-221,共6页
Chinese Journal of Respiratory and Critical Care Medicine
基金
国家自然科学基金青年基金(编号:81200049)
江苏省政府留学奖学金(编号:JS-2013-060)
关键词
肺纤维化
肺癌
生存时间
临床特征
Pulmonary fibrosis
Lung cancer
Survival
Clinical variables
