非小细胞肺癌患者生存状况的 Cox 多因素分析

目的：回顾性分析非小细胞肺癌（NSCLC ）患者的临床资料和生存状况，探讨影响其生存的主要因素。方法查阅和随访372例NSCLC患者的病历资料和生存状况，采用Kaplan-Meier法计算生存率，并将各个变量纳入Cox模型，用向前逐步回归法进行分析，判断影响NSCLC患者生存的相关因素。结果372 NSCLC患者中有效病例350例，失访22例，失访率为5．91％，其中Ⅰ期62例（17．71％），Ⅱ期125例（35．71％），Ⅲ A 期82例（23．43％），ⅢB期40例（11．43％），Ⅳ期41例（11．71％）。各期间生存率比较差异具有统计学意义（P＜0．05）；Cox单因素和多因素分析显示 T NM 分期是影响患者生存的1个独立高危因素，而手术方式、是否含铂类药物和Karnofsky评分值是提高患者生存时间的3个主要因素。结论 TNM分期、手术方式、化疗方案和Karnofsky评分是影响NSCLC患者生存的独立因素。

Cox multivariate analysis on the survival situation of non-small cell lung cancer patients

Objective To analyze the clinical and survival data of non-small cell lung cancer （NSCLC ） patients ,and to explore the main factors affecting their survival .Methods Medical records and survival data of 372 cases of NSCLC patients were inspected and followed up ,the Kaplan-Meier method was used to calculate the survival , and included the variables were analyzed in the Cox model ,the relevant factors were used forward stepwise regression analysis to determine the impact on the survival of patients with NSCLC .Results 350 cases of 372 NSCLC patients were valid cases ,and 22 cases were lost ,lost rate was 5 .91% ,and 62 cases in stage Ⅰ（17 .71% ） ,125 cases in stageⅡ （35 .71% ） ,82 cases in stage ⅢA （23 .43% ） ,40 cases in stage ⅢB （11 .43% ） ,41 cases in stage Ⅳ （11 .71% ） . Survival difference was statistically significant in each period （P〈 0 .05） .Cox univariate and multivariate analysis showed that TNM staging was an independent risk factor for survival of patients ,while surgical approach ,whether platinum-containing drugs and Karnofsky scores were three main factors that increasing the survival time of patients . Conclusion TNM staging ,surgical ,chemotherapy and Karnofsky score were independent factors affecting the survival of patients with NSCLC .