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目的探讨小细胞肺癌患者发生脑转移的相关因素。方法回顾性分析118例病理确诊的小细胞肺癌患者,比较发生脑转移与未发生脑转移两组小细胞肺癌患者的临床特征。结果单因素分析发现诊断时转移器官数、NSE、LDH、一线化疗周期数、一线化疗疗效、是否接受预防性全脑放疗与患者是否发生肺癌脑转移相关。多因素分析结果显示转移器官数、NSE、一线化疗周期数与接受预防性全脑放疗是脑转移的独立影响因素。结论转移器官数≥2[OR:4.53,(95%CI:1.19~17.26),P=0.027]和NSE大于正常值4倍[OR:2.70,(95%CI:1.05~6.94),P=0.039]是小细胞肺癌患者发生脑转移的独立危险因素。一线化疗周期数≥6个周期[OR:0.28,(95%CI:0.11~0.68),P=0.005]与接受预防性全脑放疗[OR:0.49,(95%CI:0.01~0.42),P=0.006]是脑转移的保护因素。
Objective To investigate the related factors of brain metastasis in patients with small cell lung cancer. Methods A retrospective analysis of 118 cases of pathologically diagnosed small cell lung cancer patients with and without brain metastases occurred in two groups of patients with small cell lung cancer clinical features. Results Univariate analysis found that the number of metastatic organs, NSE, LDH, the number of first-line chemotherapy cycles, the efficacy of first-line chemotherapy and whether or not prophylactic whole-brain radiotherapy were related to brain metastases of patients with lung cancer at diagnosis. Multivariate analysis showed that the number of metastatic organs, NSE, first-line chemotherapy cycles and prophylactic whole-brain radiotherapy were independent influencing factors of brain metastasis. CONCLUSIONS: The number of metastatic organs ≥ 2 (OR: 2.70, 95% CI: 1.19-17.26, P = 0.027) and NSE greater than 4 times normal ] Is an independent risk factor for brain metastases in patients with small cell lung cancer. (OR: 0.28, 95% CI: 0.11-0.68, P = 0.005) were comparable with those treated with prophylactic whole brain radiation (OR: 0.49, 95% CI: = 0.006] is a protective factor of brain metastasis.