摘要
目的探讨术前预后营养指数对Ⅰ期非小细胞肺癌术后复发的预测价值。方法对178例NSCLC患者的临床资料进行回顾性研究。随访并记录所有患者的临床资料,包括性别、年龄、吸烟史、手术方式、病理类型、T分期、TNM分期、肿瘤最大直径、血管浸润、淋巴管浸润、脏层胸膜浸润、化疗次数、PNI值等资料。应用Cox单因素和多因素回归分析对影响NSCLC患者的危险因素进行分析。结果随访时间3~5年,术后复发28例,复发率15.7%。178例患者的中位生存时间为(49.5±13.6)个月,1、3、5年生存率分别为83.7%、75.3%、70.2%。单因素分析显示:手术方式(χ~2=6.982,P=0.004)、TNM分期(χ~2=5.814,P=0.021)、血管浸润(χ~2=5.942,P=0.019)、脏层胸膜浸润(χ~2=7.912,P=0.001)、化疗次数(χ~2=6.715,P=0.006)及PNI值(t=7.413,P=0.003),均为NSCLC患者预后复发的影响因素。经过Cox多因素预后复发危险分析结果显示:手术方式(HR=1.034,95%CI:0.726~1.513,P=0.009)、化疗次数(HR=0.301,95%CI:0.182~0.454,P=0.001)和PNI值(HR=0.2.314,95%CI:1.61~2.92,P=0.000)是影响NSCLC患者预后复发的独立危险因素。结论 PNI指数是预测I期非小细胞肺癌患者术后复发的独立危险因素,PNI值与I期非小细胞肺癌患者术后复发几率呈正比。
Objective To investigate the predictive value of preoperative prognostic index for postoperative recurrence of stage I non-small cell lung cancer. Methods Clinical data of 178 NSCLC patients were retrospectively studied. Follow up and re- cord the clinical data of all patients, including gender, age, smoking history, operation type, pathological type, T stage, TNM stage tumor diameter,vascular invasion, lymphatic invasion, visceral pleural invasion, number of chemotherapy, PNI value and so on. Cox single factor and multi factor regression analysis were used to analyze the risk factors of NSCLC patients. Results Follow up time was 3 -5 years,28 cases recurred after operation,the recurrence rate was 15.7%. The median survival time of 178 patients was （49.5 ± 13.6） months, 1-,3-,5-year survival rate were respectively 83.7% ,75.3% ,70.2%. Through the single factor risk analysis showed that operation type （ χ^2= 6. 982, P = 0. 004）, TNM stage （ χ^2 = 5. 814, P = 0. 021 ）, vascular invasion （χ^2 = 5. 942, P = 0.019）, visceral pleural invasion （χ^2= 7. 912, P = 0. 001 ）, the number of chemotherapy （χ^2= 6. 715, P = 0. 006） and PNI （t = 7. 413, P = 0. 003 ） were factors affecting the prognosis of patients with NSCLC recurrence. Through Cox multivariate analysis showed that operation type （ HR = 1. 034,95 % CI ： 0. 726 - 1.513, P = 0. 009 ）, the number of chemotherapy （ HR = 0. 301,95% CI：0. 182 - 0.454,P = 0. 001 ） and PNI （ HR = 0. 2. 314,95% CI ： 1.61 - 2.92 ,P = 0. 000） were independent risk factors of recurrence and prognosis of patients with NSCLC. Conclusion PNI index is an independent risk factor for predicting postoperative recurrence of patients with stage I non-small cell lung cancer, and the PNI value is proportional to the postoperative recurrence rate of patients with stage I non-small cell lung cancer.
出处
《实用癌症杂志》
2017年第10期1645-1647,共3页
The Practical Journal of Cancer
关键词
预后营养指数
非小细胞肺癌
复发
预测价值
Prognostic nutritional index
Non-small cell lung cancer
Recurrence
Predictive value
