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目的探讨影响晚期非小细胞肺癌患者生存时间的因素,建立具有临床实用价值的预后模型。方法收集184例晚期非小细胞肺癌患者临床随访资料,运用Kaplan-Meier法估计生存率并进行单因素分析,利用Cox比例风险回归模型进行多因素分析,计算个体预后指数并据此进行分组,使用Log-Rank检验进行比较。结果晚期非小细胞肺癌患者1年、2年、3年的生存率分别为53%,25%,12%。单因素和多因素分析结果显示,KPS评分、临床分期、治疗方式以及治疗前血红蛋白水平对患者生存时间有影响(P<0.05)。按照预后指数进行分组,高、中、低危组患者生存时间具有差异(P<0.001),高危组的中位生存时间为7个月,95%可信区间为5.8～8.2个月;中危组的中位生存时间为16个月,95%可信区间为14.1～17.9个月;低危组的中位生存时间为35个月,95%CI为31.1～39.8个月。结论 KPS评分、临床分期、治疗方式以及治疗前血红蛋白水平是晚期非小细胞肺癌患者生存时间的独立影响因素,根据以上因素所建立的预后指数模型具有实际应用价值。
Objective To explore the factors affecting the survival time of patients with advanced non-small cell lung cancer and establish a prognostic model with clinical value. Methods The clinical follow-up data of 184 patients with advanced non-small cell lung cancer were collected. The Kaplan-Meier method was used to estimate the survival rate and single factor analysis. The Cox proportional hazards regression model was used for multivariate analysis. Individual prognostic index was calculated and grouped accordingly. Log-Rank test for comparison. Results The survival rates of patients with advanced non-small cell lung cancer at 1 year, 2 years, and 3 years were 53%, 25%, and 12%, respectively. Univariate and multivariate analysis showed that KPS score, clinical stage, treatment and pre-treatment hemoglobin levels had an effect on survival time (P<0.05). According to the prognostic index, the survival time of the high, middle, and low risk groups was different (P<0.001), the median survival time of the high risk group was 7 months, and the 95% confidence interval was 5.8 to 8.2 months; The median survival time of the group was 16 months, with a 95% confidence interval of 14.1 to 17.9 months. The median survival time of the low-risk group was 35 months, and the 95% CI was 31.1 to 39.8 months. Conclusion The KPS score, clinical stage, treatment method and pre-treatment hemoglobin level are independent influencing factors for the survival time of patients with advanced non-small cell lung cancer. The prognostic index model established based on the above factors has practical application value.