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目的评估无法手术的晚期非小细胞肺癌患者的血红蛋白水平与治疗疗效及生存预后的关系。方法回顾分析广西肿瘤医院2005年l月至2007年1月接受初次化疗并能随访的无法手术的非小细胞肺癌280例,按性别、临床分期、病理类型分成贫血组和非贫血组。两组样本率的比较采用χ2检验,生存分析采用Kaplan-Meier法和log-rank检验;多因素分析采用Cox逐步回归模型。结果贫血降低化疗临床获益率(P<0.05),无贫血组生存期长于贫血组(P<0.001)。分层分析显示ⅢB期、Ⅳ期及腺癌、未分化癌的生存期差异有统计学意义(P<0.05),ⅢA期及腺鳞癌、鳞癌差异无统计学意义(P>0.05)。Cox模型显示贫血是非小细胞肺癌患者的独立预后因素。结论初次治疗前血红蛋白水平与非小细胞肺癌患者的临床获益率和生存时间相关,贫血是影响非小细胞肺癌患者生存的独立预后因素。
Objective To evaluate the relationship between hemoglobin level, therapeutic efficacy and survival and prognosis in patients with advanced non-small cell lung cancer who can not be operated. Methods 280 cases of inoperable non-small cell lung cancer who underwent primary chemotherapy in Guangxi Cancer Hospital from January 2005 to January 2007 were retrospectively analyzed. According to gender, clinical stage and pathological type, anemia group and non-anemia group were divided into two groups. Chi-square test was used to compare the two sample rates, Kaplan-Meier method and log-rank test were used for survival analysis, and Cox stepwise regression was used to analyze the multivariate analysis. Results Anemia reduced the clinical benefit of chemotherapy (P <0.05), and the anemia-free survival was longer than that of anemia (P <0.001). Stratified analysis showed that there were significant differences in survival between stage ⅢB, stage Ⅳ, adenocarcinoma and undifferentiated carcinoma (P <0.05). There was no significant difference between stage ⅢA, adenosquamous carcinoma and squamous cell carcinoma (P> 0.05). Cox model shows that anemia is an independent prognostic factor in patients with non-small cell lung cancer. Conclusions The hemoglobin level before initial treatment is related to the clinical benefit rate and survival time in patients with non-small cell lung cancer. Anemia is an independent prognostic factor affecting the survival of non-small cell lung cancer patients.