117例小细胞肺癌患者临床特征与预后分析

目的:分析小细胞肺癌患者临床特征和影响其预后的因素。方法:收集 2007年 7 月至 2010 年7 月淄博市第一医院收治的经病理组织学证实、有完整随访资料的 117例小细胞肺癌患者的临床资料。回顾性分析小细胞肺癌患者临床特征、复发及生存情况。单因素分析采用Kaplan-meier法生存分析，进行Log-rank非参数检验，多因素分析采用Cox 回归分析。结果:全组1年生存率为71.8%，2年生存率为35.9%，3年生存率为12.8%。局限期1年生存率为76.9%，2年生存率为46.2%，3年生存率为19.2%；广泛期1年生存率为61.5%，2年生存率为15.4%，3年生存率为0,两者差异有统计学意义(P=0．000)。全组中位生存时间20个月，局限期中位生存时间22个月，广泛期中位生存时间12个月，两者差异有统计学意义(P=0．000)。单因素分析发现年龄、分期、化疗周期数、治疗方式均可影响患者的生存时间。多因素分析提示分期、治疗方式是影响小细胞肺癌预后的主要因素。结论:分期、治疗方式是小细胞肺癌的独立预后因素，应争取早诊断、早治疗（采用放化疗、手术等综合治疗方式）。

Clinical characteristics and prognosis of 117 cases with small cell lung cancer

To analyze the clinical characteristics and prognostic factors of patients with small cell lung cancer（SCLC）. Methods：The data of 117 patients with small cell lung cancer were reviewed retrospectively. The cor-relation between gender,age,stage,chemotherapy cycles and methods of treatment with survival were evaluated. The survival was evaluated by Kaplan - meier and multivariate analysis was performed by Cox proportional hazards model. Results：Of 117 patients 1 - ,2 - ,3 - year survival rates were 71. 8% ,35. 9% ,12. 8% ,in limited disease （LD）patients,1 - ,2 - ,3 - year survival rates were 76. 9% ,46. 2% ,19. 2% ,in extended disease（ ED）patients, 1 - ,2 - ,3 - year survival rates were 61. 5% ,15. 4% ,0（P = 0. 000）. Median survival time（MST）of all the pa-tients was 20 months,22 months in LD,12 months in ED（P = 0. 000）. Univariate analysis indicated that age,stage, chemotherapy cycles and methods of treatment were significandy related to the survival. By multivariate analysis,stage and methods of treatment were independent prognostic factors of survival. Conclusion：Stage and methods of treatment were independent prognostic factors of survival in SCLC. SCLC should be diagnosed and treated at early stage,and treated with combined therapy.