摘要
目的调查慢阻肺合并肺癌诊断现状,比较临床特征,探讨慢阻肺合并NSCLC预后影响因素。方法收集979例首诊原发性肺癌患者,分为单纯肺癌组833例,慢阻肺合并肺癌组146例,慢阻肺合并NSCLC组123例。SPSS 22.0统计软件分析诊断现状、临床特征、GOLD分级和预后的关系,采用Kaplan-Meier法制作生存曲线,探讨预后影响因素。结果诊断现状:确诊率、未诊断率:14.91%、30.13%。临床特征:慢阻肺合并肺癌组男性、年龄≥65岁、有吸烟史、中央型肺癌、鳞癌患者比例均高于单纯肺癌组(P<0.05)。预后分析:全组中位OS 14.02月,12、24、36月生存率分别:59.14%、26.72%、17.31%。GOLD分级生存分析:Ⅰ级、Ⅱ级、Ⅲ/Ⅳ级中位OS分别:18.96月、13.08月、7.96月,Log-Rank比较P=0.005。Cox单因素和多因素分析:年龄≥65岁、低BMI、PS评分≥2分、TNMⅢ、Ⅳ期、GOLDⅡ、Ⅲ/Ⅳ级和放化疗、保守治疗是影响慢阻肺合并NSCLC预后不良的独立危险因素(P<0.05)。结论慢阻肺合并肺癌确诊率低,未诊断率高,肺癌中男性、年龄≥65岁、有吸烟史、中央型肺癌、鳞癌易合并慢阻肺,合并慢阻肺影响NSCLC患者总体生存率和预后。
Objective To investigate the current diagnosis status of COPD patients complicated with lung cancer,compare their clinical characteristics,and explore the prognostic factors of COPD patients complicated with NSCLC.Methods A total of 979 patients with primary lung cancer were divided into the simple lung cancer group(833 cases),the COPD with lung cancer group(146 cases)and the COPD with NSCLC group(123 cases).Spss22.0 statistical software was used to analyze the relationship between diagnosis and occupational status,clinical features,gold grade and prognosis.Kaplan Meier method was used to make survival curve to explore the influencing factors of prognosis.Results For diagnosis status,its confirmed rate and undiagnosed rate was 14.91%and 30.13%.For clinical features,the proportion of male,aged≥65 years,smoking history,central type,and squamous cell carcinoma was higher in the COPD with lung cancer group than in the simple lung cancer group(P<0.05).For prognostic analysis,the median OS of the entire group was 14.02 months,and the survival rate at the 12th,24th,and 36th months were 59.14%,26.72%,and 17.31%,respectively.GOLD graded survival analysis showed that median OS for grades I,Ⅱ,andⅢ/Ⅳwere 18.96,13.08,and 7.96 months,respectively,with a P value of 0.0046 for Log Rank comparison.Cox univariate and multivariate analysis showed that age≥65 years,BMI,PS score≥2,TNM stageⅢ,Ⅳ,GOLDⅡ,Ⅲ/Ⅳ,radiotherapy,chemotherapy,and conservative treatment were independent risk factors for poor prognosis of COPD patients complicated with NSCLC(P<0.05).Conclusion The diagnostic rate of chronic obstructive pulmonary disease(COPD)complicated with lung cancer is low,and the undiagnosed rate is high.Among lung cancer patients,those who are male,aged≥65 years,having a history of smoking,central type and squamous cell carcinoma are prone to COPD.The presence of COPD affects the overall survival rate and prognosis of NSCLC patients.
作者
吴漫
吴健卫
徐非洲
石建邦
张佳秀
刘恋
湛云飞
左文文
芦胜胜
WU Man;WU Jianwei;XU Feizhou;SHI Jianbang;ZHANG Jiaxiu;LIU Lian;ZHAN Yunfei;ZUO Wenwen;LU Shengsheng(Respiratory Department,Jiujiang First People′s Hospital,Jiujiang,Jiangxi 332000,China;Pain Department,Jiujiang First People′s Hospital,Jiujiang,Jiangxi 332000,China)
出处
《临床肺科杂志》
2025年第2期219-225,共7页
Journal of Clinical Pulmonary Medicine
基金
江西省卫生健康委科技计划(No.SKJP1220240151)。
关键词
慢性阻塞性肺疾病
肺癌
现状调查
临床特征
预后
chronic obstructive pulmonary disease
lung cancer
investigation of current situation
clinical features
prognosis
作者简介
通信作者:芦胜胜,E-mail:2387824118@qq.com。
