中国肺癌杂志2025，Vol.28Issue(4)：267-280,14.DOI:10.3779/j.issn.1009-3419.2025.101.06
非手术干预的肺腺癌患者发生脑膜转移的危险因素分析
Analysis of Risk Factors for Meningeal Metastasis in Patients with Lung Adenocarcinoma Following Non-surgical Interventions
摘要
Abstract
Background and objective Meningeal metastasis(MM)is a form of malignant metastasis where tumor cells spread from the primary site to the pia mater,dura mater,arachnoid,subarachnoid space,and other cerebrospinal fluid compartments.Lung cancer is one of the most common malignant tumor types with MM.MM not only signifies that the lung cancer has progressed to an advanced stage but also leads to a range of severe clinical symptoms due to meningeal involvement.Currently,the risk factors associated with the development of MM are not fully elucidated.The aim of this study was to inves-tigate the risk factors for MM in patients with lung adenocarcinoma(LUAD)who underwent non-surgical interventions,in order to identify LUAD patients at high risk for MM.Methods This retrospective study analyzed the clinical data of patients diagnosed with LUAD at the First Affiliated Hospital of Zhengzhou University from January 2020 to July 2024.Missing data were imputed using multiple imputation methods,and risk factors were identified through LASSO,univariate,and multivari-ate Logistic regression analyses.Results A total of 170 patients with LUAD were included in this study and divided into two groups:87 patients with MM and 83 patients without MM.Univariate and multivariate Logistic regression analyses revealed that younger age at diagnosis(P=0.004),presence of the epidermal growth factor receptor(EGFR)L858R gene mutation(P=0.008),and concurrent liver metastasis at baseline(P=0.004)were independent risk factors for developing MM in LUAD patients who did not undergo surgical intervention.Conversely,higher baseline globulin levels(P=0.039)and the presence of the anaplastic lymphoma kinase(ALK)gene mutation(P=0.040)were associated with a reduced risk of MM development.Conclusion Age at diagnosis,EGFR L858R mutation status,ALK gene mutation status,concurrent liver metastasis,globulin levels at baseline were significantly associated with the risk of developing MM in patients with LUAD patients who did not undergo surgical intervention.For patients diagnosed at a younger age,carrying the EGFR L858R mutation,or presenting with baseline liver metastasis,early implementation of tertiary prevention strategies for MM is crucial.Regular monitoring of MM status should be conducted in these high-risk groups.关键词
肺肿瘤/脑膜转移/危险因素/肝转移/EGFR L858R突变Key words
Lung neoplasms/Meningeal metastasis/Risk factors/Liver metastases/EGFR L858R mutation引用本文复制引用
岳毅,付俊凯,孔萌蕊,张国俊,任雨晴,林剑泷,卢春亚,姜楠,苏彦平,李靖,王一博,王思慧..非手术干预的肺腺癌患者发生脑膜转移的危险因素分析[J].中国肺癌杂志,2025,28(4):267-280,14.基金项目
本研究受国家自然科学基金项目(No.81874042)资助 This study was supported by the grant from National Natural Science Foundation of China(No.81874042)(to Guojun ZHANG). （No.81874042）
