[1]许子寒,郑林鹏,杨峤,等.非小细胞肺癌的转移特征及预后分析[J].第三军医大学学报,2019,41(09):871-876.
 XU Zihan,ZHENG Linpeng,YANG Qiao,et al.Metastatic characteristics and prognosis of non-small cell lung cancer[J].J Third Mil Med Univ,2019,41(09):871-876.
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非小细胞肺癌的转移特征及预后分析(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
41卷
期数:
2019年第09期
页码:
871-876
栏目:
临床医学
出版日期:
2019-05-15

文章信息/Info

Title:
Metastatic characteristics and prognosis of non-small cell lung cancer
作者:
许子寒郑林鹏杨峤李奉余永新孙建国
400037 重庆,陆军军医大学(第三军医大学)第二附属医院全军肿瘤研究所
Author(s):
XU Zihan ZHENG Linpeng YANG Qiao LI Feng YU Yongxin SUN Jianguo

Cancer Institute, Second Affiliated Hospital, Army Medical University(Third Military Medical University), Chongqing, 400037, China

关键词:
转移模式预后SEER数据库非小细胞肺癌组织学亚型
Keywords:
metastatic pattern prognosis SEER database non-small cell lung cancer histological subtype
分类号:
R181.23; R73-37; R734.2
文献标志码:
A
摘要:

目的基于大量人群的数据集,分析非小细胞肺癌(nonsmall cell lung cancer, NSCLC)转移部位的特异性及不同转移模式的预后差异。方法从SEER(Surveillance, Epidemiology, and End Results)数据库中收集2010-2014年诊断为NSCLC的转移性患者,利用Kaplan-Meier法和对数秩检验进行生存分析,通过Cox比例风险模型分析改善总体生存(overall survival, OS)的相关因素。结果从SEER数据库中收集到38 755例具有骨、肝、脑、肺任一部位转移的NSCLC患者。诊断时,年龄超过50岁的患者占93.89%,且以白种人为主(77.38%)。入组患者中,肿瘤中度分化(Ⅱ级)患者约占12.50%,肿瘤低分化(Ⅲ级)患者占25.55%,组织学亚型以腺癌为主,约占72.52%。对于所有NSCLC患者,最常见的单转移部位是骨(22.43%),最少累及的部位是肝(5.87%),骨和肺是最常见的双部位转移组合(7.40%),骨、肝和肺是最常见的三部位转移组合(3.16%)。孤立性肝转移在单转移中具有最差的OS(P<0.001),多部位转移中,含有肝转移的组合也具有更差的OS(P<0.001)。结论NSCLC不论是单个还是多个器官转移,骨都是最常累及的靶器官。单独肝转移或多部位联合肝转移的NSCLC患者预后较差,孤立性肺转移预后最好。

Abstract:

ObjectiveTo analyze the specificity of metastatic sites and prognostic differences of different metastatic patterns in non-small cell lung cancer (NSCLC) based on a large population-based dataset. MethodsThe metastatic NSCLC patients diagnosed between 2010 and 2014 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier survival analysis and log-rank test were used for survival analysis, and Cox proportional hazard model was performed to determine the factors related to improved overall survival (OS). ResultsA total of 38 755 NSCLC cases with metastases to bone, liver, brain and/or lungs were collected from the SEER database. At the time of diagnosis, 93.89% of the patients were over the age of 50 years, and the caucasian accounted for 77.38%. Among all enrolled cases, the moderately differentiated tumors (grade Ⅱ) accounted for 12.50%, and those with poor differentiation (grade Ⅲ) for 25.55%. The major histological subtype was adenocarcinoma, accounting for 72.52%. The most common single metastatic site was bone (22.43%), and the least common was liver (5.87%) for NSCLC. As for multisite metastases, bone and lung was the most common 2-site metastasis (7.40%), and bone, liver and lung was the most common 3-site metastasis (3.16%). An isolated liver metastasis had the worst OS among single metastasis (P<0.001). Furthermore, for patients with multisite metastases, liver combined metastases had worst OS among various combinations(P<0.001). ConclusionFor NSCLC, bone is the most commonly targeted site, no matter for single- or multi-organ metastases. NSCLC patients with metastasis to liver alone or in combination with other organs have a poorer prognosis, while isolated lung metastasis has the best outcomes.
 

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更新日期/Last Update: 2019-05-08