【摘要】：目的探討老年非小細胞肺癌(NSCLC)合并慢性阻塞性肺疾病(COPD)患者的臨床特點、治療策略及預后,為臨床診治狀況提供合理建議。方法回顧性收集2000年1月~2015年6月之間,在解放軍總醫(yī)院老年病區(qū)就診的年齡在60以上,新診斷NSCLC并COPD的患者的臨床資料。主要收集的臨床數據包括:吸煙習慣,肺功能檢測,起始治療策略,TNM分期,主訴癥狀,合并疾病和實驗室化驗等。應用COX比例風險回歸模型進行多因素分析。結果回顧性總結200例NSCLC患者,其中107例(53.5%)通過吸入支氣管擴張劑并通過肺功能測試,確診合并COPD,納入本研究。全組患者中位生存時間45.8月,1、3、5、10年生存率分別為80.4%、55.4%、41.0%、20.0%。分層分析顯示COPD Gold分級為1度和2度患者的總生存時間顯著長于Gold 3度和4度的患者(Gold 1 vs.3/4∶51.7月vs 16.9月,P=0.020;Gold 2 vs 3/4∶43.1月vs 16.9月,P=0.043)。利用Cox比例風險回歸模型進行單因素和多因素分析顯示,年齡增大,Gold分級越重,治療3個月內Gold分級未改善,TNM分期越晚(Ⅲ和Ⅳ期),病理類型為鱗癌,起始治療非手術,以及主訴癥狀為咳嗽和較高的血清CEA值是影響生存預后的獨立危險因子。結論研究發(fā)現影響本組老年NSCLC-COPD患者生存預后的因素有很多,其中COPD Gold分級越重,治療3個月內Gold分級未改善是其中的獨立危險因子。
[Abstract]:Objective to investigate the clinical characteristics, treatment strategy and prognosis of elderly patients with (NSCLC) complicated with chronic obstructive pulmonary disease (COPD), and to provide reasonable advice for clinical diagnosis and treatment. Methods from January 2000 to June 2015, the clinical data of patients who were over 60 years old and newly diagnosed with NSCLC and COPD in the geriatric area of PLA General Hospital were collected retrospectively. The main clinical data collected include: smoking habit, pulmonary function test, initial treatment strategy, TNM staging, main complaint symptoms, combined diseases and laboratory tests. COX proportional risk regression model was applied to multivariate analysis. Results among the 200 NSCLC patients, 107 (53.5%) were diagnosed by bronchiectasis and pulmonary function test. The median survival time of the whole group was 45.8 months, and the 10-year survival rate was 80.4 and 55.45.45.40, respectively. Stratified analysis showed that the total survival time of patients with COPD Gold grade 1 and 2 was significantly longer than that of patients with 3 and 4 degrees of Gold (Gold 1 vs.3/4:51.7 month vs 16.9 months, Gold 0.020 months); Gold 2 vs 3: 4: 43.1 vs 16.9, vs 0.043. Univariate and multivariate analysis using Cox proportional risk regression model showed that the older the age, the more severe the Gold grade was, and the later the TNM stage (鈪，

本文編號：2365127