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合并特发性肺纤维化对非小细胞肺癌手术患者预后的影响

Effect of idiopathic pulmonary fibrosis on postoperative prognosis of patients with non-small cell lung cancer

  • 摘要:
    目的  探讨合并特发性肺纤维化(IPF)对非小细胞肺癌(NSCLC)患者术后预后的影响。
    方法  选择2018年3月至2019年3月在西安交通大学附属红会医院接受根治性手术治疗的NSCLC患者98例,分为IPF组、无IPF组。比较两组临床病理资料及手术相关情况。随访至2024年3月31日,终点事件为NSCLC相关死亡或NSCLC复发,记录随访期间死亡及复发情况。绘制Kaplan-Meier生存曲线,采用log-rank检验比较两组生存率。采用Cox回归分析影响NSCLC患者术后死亡、复发的相关因素。
    结果  98例患者中,有IPF 45例(45.92%)。与无IPF组相比,IPF组年龄较大,女性患者比例、术前血清C反应蛋白(CRP)水平较高,术前血清白蛋白水平较低(P<0.05)。中位随访3.7(0.7,5.6)年,IPF组患者的1、3、5年总生存率、无复发生存率均低于无IPF组(P<0.05)。Cox回归分析显示,中高分化程度、合并IPF是NSCLC患者生存的危险因素(P<0.05);血管浸润、肿瘤较大、有IPF是导致NSCLC复发的危险因素(P<0.05)。
    结论  对于NSCLC患者,合并IPF可降低总生存率与无复发生存率,是导致其术后死亡、复发的共同危险因素。

     

    Abstract:
    Objective To investigate the effect of idiopathic pulmonary fibrosis (IPF) on the prognosis of patients with non-small cell lung cancer ( NSCLC ).
    Methods A total of 98 patients with NSCLC who underwent radical surgery in Honghui Hospital, Xi’an Jiaotong University from March 2018 to March 2019 were selected, and were divided into the IPF group and the non-IPF group. The clinicpathological and surgical data were compared between the two groups. The follow-up time was up to March 31, 2024. The endpoint event was NSCLC-related death or NSCLC recurrence, and the death and recurrence during the follow-up period were recorded. Kaplan-Meier survival curve and log-rank test were used to compare survival rate between the two groups. Cox regression analysis was used to analyze the related factors affecting postoperative death and NSCLC recurrence.
    Results Of the 98 patients included, 45 (45.92%) had IPF. Compared with the non-IPF group, the patients were older, proportion of female patients and preoperative serum C-reactive protein (CRP) level were higher, and the preoperative serum albumin level was lower in the IPF group (P<0.05). The median follow-up time was 3.7(0.7, 5.6)years. The 1-, 3-, 5-year overall survival rates and recurrence-free survival rates of patients in the IPF group were shorter than those in the non-IPF group (P<0.05). Cox regression analysis showed that high-degree differentiation and IPF were risk factors for survival of NSCLC patients (P<0.05), and vascular infiltration, bigger tumor and IPF were risk factors resulting in NSCLC recurrence (P<0.05).
    Conclusions  For NSCLC patients, IPF can significantly shorten the overall survival and recurrence-free survival, and is a common risk factor resulting in postoperative death and recurrence.

     

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