摘要
目的探讨血清白蛋白对接受全身化疗的老年晚期非小细胞肺癌(NSCLC)患者预后的预测价值。方法选取2012年1月至2018年1月在我院确诊的老年晚期NSCLC患者92例,根据不同治疗方案不同分为化疗组(n=50)和最佳支持治疗组(BSC组,n=42)。比较两组患者的临床参数和预后差异,采用单因素及多因素Logistic回归对患者预后因素进行分析。根据血清白蛋白水平,分别比较不同血清白蛋白水平患者接受化疗或BSC治疗生存时间的差异。结果在老年晚期NSCLC患者中,化疗组和BSC组的中位生存时间(mOS)分别是8个月和5.2个月(P=0.003)。单因素和多因素分析结果均显示脑转移和血清白蛋白水平是接受全身化疗的老年晚期NSCLC预后的独立影响因素。通过ROC曲线分析确定血清白蛋白水平最佳临界值为3.2 g/dl时,灵敏度为86.2%,特异度为65.5%。在患者血清白蛋白≥3.2 g/dl时,化疗组和BSC组的mOS分别为:12个月和5.8个月(P<0.001);在患者血清白蛋白<3.2 g/dl时,化疗组和BSC组的mOS分别为:6.2个月和4.8个月(P>0.05)。结论低蛋白血症是老年晚期NSCLC患者预后不良的独立危险因素,治疗前检测血清白蛋白水平对实现患者的个体化治疗有一定指导意义。
Objective To investigate the predictive value of serum albumin in the prognosis of elderly patients with advanced non-small cell lung cancer (NSCLC) undergoing systemic chemotherapy. Methods Ninety-two elderly patients with advanced NSCLC diagnosed in our hospital between January 2012 and January 2018 were included in the study. According to different treatment methods, all patients were divided into chemotherapy group (n=50) and best supportive care group (BSC group, n=42). The differences in the clinical parameters and prognosis between the two groups were compared. The prognostic factors were determined by univariate and multivariate Logistic regression analysis. According to serum albumin level, the differences in the survival time between patients with different serum albumin levels receiving chemotherapy or BSC were compared. Results The median overall survival (mOS) time in the elderly patients with advanced NSCLC was 8 and 5.2 months in the chemotherapy and BSC groups, respectively (P=0.003). Univariate and multivariate analyses showed that brain metastasis and serum albumin level were independent prognostic factors for elderly patients with advanced NSCLC undergoing systemic chemotherapy. When the optimal cut-off value of serum albumin level was 3.2 g/dl, which was determined by ROC curve analysis, the sensitivity and specificity were 86.2% and 65.5%, respectively. When the serum albumin level≥3.2 g/dl, the mOS time was 12 and 5.8 months in the chemotherapy and BSC groups, respectively (P<0.001). When the serum albumin level <3.2 g/dl, the mOS time was 6.2 and 4.8 months in the chemotherapy and BSC groups, respectively (P<0.001). Conclusion Hypoproteinemia is an independent risk factor for poor prognosis in elderly patients with advanced NSCLC. Examination of serum albumin level at the baseline shows certain guiding significance for individualized treatment of patients.
作者
徐小峰
戴宏宇
乔建兵
夏春伟
Xu Xiaofeng;Dai Hongyu;Qiao Jianbing;Xia Chunwei(Department of Respiratory Medicine, Nanjing Chest Hospital, Nanjing, Jiangsu 210029, China)
出处
《中华生物医学工程杂志》
CAS
2019年第3期346-350,共5页
Chinese Journal of Biomedical Engineering
关键词
血清白蛋白
非小细胞肺癌
全身化疗
最佳支持治疗
预后
Serum albumin
Non-small cell lung cancer
Systemic chemotherapy
Best supportive care
Prognosis
