晚期非小细胞肺癌患者生存时间影响因素分析

目的探讨影响晚期非小细胞肺癌患者生存时间的因素,建立具有临床实用价值的预后模型。方法收集184例晚期非小细胞肺癌患者临床随访资料,运用Kaplan-Meier法估计生存率并进行单因素分析,利用Cox比例风险回归模型进行多因素分析,计算个体预后指数并据此进行分组,使用Log-Rank检验进行比较。结果晚期非小细胞肺癌患者1年、2年、3年的生存率分别为53%,25%,12%。单因素和多因素分析结果显示,KPS评分、临床分期、治疗方式以及治疗前血红蛋白水平对患者生存时间有影响(P0.05)。按照预后指数进行分组,高、中、低危组患者生存时间具有差异(P0.001),高危组的中位生存时间为7个月,95%可信区间为5.8～8.2个月;中危组的中位生存时间为16个月,95%可信区间为14.1～17.9个月;低危组的中位生存时间为35个月,95%CI为31.1～39.8个月。结论 KPS评分、临床分期、治疗方式以及治疗前血红蛋白水平是晚期非小细胞肺癌患者生存时间的独立影响因素,根据以上因素所建立的预后指数模型具有实际应用价值。

Analysis on Influencing Factors of Survival Time of Advanced Non-small Cell Lung Cancer

Objective To explore the factors on survival time of advanced non-small cell lung cancer （NSCLC） and establish a reliable model of clinical prognostic index （PI）. Methods 184 cases with advanced NSCLC were selected, Kaplan-Meier method was used to calculate survival rate and univariate analysis was done, proportional - hazards regression model （Cox model） was used to do multivariate analysis, patients were classified into different hazards by PI and their Kaplan-Meier survival curves were compared by log-rank test. Results The study showed that over-all sun＇ival rates were 53% at 1 year, 25% at 2 year and 12% at 3 year. The results of multivariate and univariate analysis showed that the KPS, clinical stage, therapy method and pre- treatment hemoglobin level were independent prognostic factors （P〈0.05）. There were distinct differences in survival time among the 3 groups classified by PI （P〈0.01）. The median survival time and 95%CI for high-risk group, middle-risk group, low-risk group were 7 （5.8～8.2） months, 16 （14.1～17.9） months, 35 （31.1～39.8） months. Conclusion The KPS, clinical stage, therapy method and pre-treatmem hemoglobin level were independent prognostic factors for advanced NSCLC. PI calculated on the basis of above factors is recommended to predict the survival period of advanced NSCLC.