南方医科大学学报2017，Vol.37Issue(7)：889-894,6.DOI:10.3969/j.issn.1673-4254.2017.07.06
老年非小细胞肺癌合并慢性阻塞性肺病患者的临床特征
Clinical characteristics and risk factors affecting outcomes of elderly patients with non-small cell lung cancer complicated by chronic obstructive pulmonary disease
摘要
Abstract
Objective To investigate the clinical features, treatment strategy and risk factors affecting the prognosis of elderly patients with non-small cell lung cancer (NSCLC) complicated by chronic obstructive pulmonary disease (COPD). Methods We retrospectively analyzed the data of elderly patietns (>60 years) with newly diagnosed NSCLC complicated by COPD at the Geriatric Institution of General Hospital of PLA between January, 2000 and June, 2015. The clinical data collected included history of smoking, pulmonary function test results, initial treatments, TNM stage, chief complaints, comorbidities and laboratory tests. The Cox proportional hazards regression model was used to explore the prognostic factors in these patients. Results A total of 200 NSCLC patients were reviewed, of which 107 (53.5%) patients had the co-morbidity of COPD as confirmed by spirometry using bronchodilator test. The median survival of the patients with NSCLC complicated by COPD was 45.8 months with 1-, 3-, 5-, and 10-year survival rates of 80.4%, 55.4%, 41.0%and 20.0%, respectively. Stratification analysis showed that patients with COPD Gold grades 1 and 2 had a significant longer median overall survival (51.7 and 43.1 months, respectively) than those with grade 3/4 (16.9 months; P=0.020 and 0.043, respectively). Univariate and multivariate analyses using Cox proportional hazards regression model showed that an older age, a higher Gold grade, advanced disease stage (stages III and IV), squamous cell carcinoma, nonsurgical initial treatment, coughing and an elevated serum CEA level were independent risk factors for shorter survival of the patients. Conclusion Multiple prognostic factors can affect the outcomes of elderly patients with NSCLC complicated by COPD, and a higher COPD Gold grade that fails to respond to treatment within 3 months is the independent risk factor for survival of the patients.关键词
慢性阻塞性肺病/非小细胞肺癌/临床特征Key words
chronic obstructive pulmonary disease/non-small cell lung cancer/clinical features引用本文复制引用
王鹏,张东,郭学光,孙宝君,方向群,曲歌平,刘长庭..老年非小细胞肺癌合并慢性阻塞性肺病患者的临床特征[J].南方医科大学学报,2017,37(7):889-894,6.基金项目
国家重点基础研究发展计划(973计划)(2014CB744400) Supported by National Key Basic Research Program (2014CB744400). （973计划）
