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-  2016 

53例肺纤维化合并肺癌患者的临床特征及生存分析

DOI: doi:10.7507/1671-6205.2016052

Keywords: 肺纤维化, 肺癌, 生存时间, 临床特征

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Abstract:

目的总结肺纤维化(PF)合并肺癌(LC)的临床特征,分析PF-LC患者的预后和影响因素。 方法收集2008年1月至2014年3月期间住院PF患者中确诊LC患者53例,采用Cox回归模型分析多种临床因素对生存的影响;并通过Kaplan-Meier法计算中位生存期(MST)及总生存时间(OS),绘制生存曲线,比较不同临床因素对预后的作用。 结果53例PF-LC患者中,男性(n=48,90.6%)及吸烟(n=42,79.2%)患者多见,平均年龄(68.6±9.5)岁。通过Cox回归模型,对年龄、吸烟史、胸痛、Velcro啰音、PF类型、LC临床分期、LC治疗等因素分析显示,Velcro啰音(P=0.009)及临床分期(P=0.013)是PL-LC患者预后的独立影响因素。全组患者MST为6.0个月,1年、2年生存率分别为34.1%、22.0%。53例患者中,特发性PF-LC 42例(79.2%),继发性PF-LC 11例(20.8%);两组OS差异无统计学意义。不同LC病理类型患者中,NSCLC组(n=37)的OS较SCLC(n=6)及未分类组(10例)显著延长(P=0.035)。不同LC临床分期患者,Ⅰ期+Ⅱ期患者(n=13)较Ⅲ期+Ⅳ期患者(n=40)OS显著延长(P=0.002)。治疗上,针对LC治疗组(n=31)较未治疗组(n=22)MST及OS均显著延长(P < 0.001);采取综合治疗方案组(n=11)较单一方案治疗组(n=20)的OS显著延长(P=0.036)。 结论Velcro啰音及LC临床分期是影响PF-LC患者预后的独立危险因素。治疗上,建议针对LC采用综合治疗方案,以延长患者的生存期

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