非小细胞肺癌的转移特征及预后分析

许子寒; 郑林鹏; 杨峤; 李奉; 余永新; 孙建国

doi:10.16016/j.1000-5404.201811089

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非小细胞肺癌的转移特征及预后分析

临床医学 | 更新时间：2026-01-09

- 非小细胞肺癌的转移特征及预后分析
- Metastatic characteristics and prognosis of non-small cell lung cancer
- 第三军医大学学报 2019年41卷第9期页码：871-876
- 作者机构：
  
  400037 重庆，陆军军医大学(第三军医大学)第二附属医院全军肿瘤研究所
- 作者简介：
  
  [孙建国，E-mail:sunjg09@aliyun.comSUN Jianguo, E-mail:sunjg09@aliyun.com
- 基金信息：
  
  国家自然科学基金青年科学基金(8160111873)
- DOI：10.16016/j.1000-5404.201811089
  中图分类号： R181.23;R73-37;R734.2
- 收稿：2018-11-13，
  
  修回：2019-02-11，
  
  纸质出版：2019-05-15
- 稿件说明：
移动端阅览
许子寒, 郑林鹏, 杨峤, 等. 非小细胞肺癌的转移特征及预后分析[J]. 第三军医大学学报, 2019,41(9):871-876.

Zihan XU, Linpeng ZHENG, Qiao YANG, et al. Metastatic characteristics and prognosis of non-small cell lung cancer[J]. Journal of Third Military Medical University, 2019, 41(9): 871-876.
许子寒, 郑林鹏, 杨峤, 等. 非小细胞肺癌的转移特征及预后分析[J]. 第三军医大学学报, 2019,41(9):871-876. DOI： 10.16016/j.1000-5404.201811089.

Zihan XU, Linpeng ZHENG, Qiao YANG, et al. Metastatic characteristics and prognosis of non-small cell lung cancer[J]. Journal of Third Military Medical University, 2019, 41(9): 871-876. DOI： 10.16016/j.1000-5404.201811089.

摘要

目的

基于大量人群的数据集，分析非小细胞肺癌(non-small cell lung cancer

NSCLC)转移部位的特异性及不同转移模式的预后差异。

方法

从SEER(Surveillance

Epidemiology

and End Results)数据库中收集2010-2014年诊断为NSCLC的转移性患者，利用Kaplan-Meier法和对数秩检验进行生存分析，通过Cox比例风险模型分析改善总体生存(overall survival

OS)的相关因素。

结果

从SEER数据库中收集到38 755例具有骨、肝、脑、肺任一部位转移的NSCLC患者。诊断时，年龄超过50岁的患者占93.89%，且以白种人为主(77.38%)。入组患者中，肿瘤中度分化(Ⅱ级)患者约占12.50%，肿瘤低分化(Ⅲ级)患者占25.55%，组织学亚型以腺癌为主，约占72.52%。对于所有NSCLC患者，最常见的单转移部位是骨(22.43%)，最少累及的部位是肝(5.87%)，骨和肺是最常见的双部位转移组合(7.40%)，骨、肝和肺是最常见的三部位转移组合(3.16%)。孤立性肝转移在单转移中具有最差的OS(

0.001)，多部位转移中，含有肝转移的组合也具有更差的OS(

0.001)。

结论

NSCLC不论是单个还是多个器官转移，骨都是最常累及的靶器官。单独肝转移或多部位联合肝转移的NSCLC患者预后较差，孤立性肺转移预后最好。

Abstract

Objective

To analyze the specificity of metastatic sites and prognostic differences of different metastatic patterns in non-small cell lung cancer (NSCLC) based on a large population-based dataset.

Methods

The metastatic NSCLC patients diagnosed between 2010 and 2014 were collected from the Surveillance

Epidemiology

and End Results (SEER) database. Kaplan-Meier survival analysis and log-rank test were used for survival analysis

and Cox proportional hazard model was performed to determine the factors related to improved overall survival (OS).

Results

A total of 38 755 NSCLC cases with metastases to bone

liver

brain and/or lungs were collected from the SEER database. At the time of diagnosis

93.89% of the patients were over the age of 50 years

and the caucasian accounted for 77.38%. Among all enrolled cases

the moderately differentiated tumors (grade Ⅱ) accounted for 12.50%

and those with poor differentiation (grade Ⅲ) for 25.55%. The major histological subtype was adenocarcinoma

accounting for 72.52%. The most common single metastatic site was bone (22.43%)

and the least common was liver (5.87%) for NSCLC. As for multi-site metastases

bone and lung was the most common 2-site metastasis (7.40%)

and bone

liver and lung was the most common 3-site metastasis (3.16%). An isolated liver metastasis had the worst OS among single metastasis (

0.001). Furthermore

for patients with multi-site metastases

liver combined metastases had worst OS among various combinations(

0.001).

Conclusion

For NSCLC

bone is the most commonly targeted site

no matter for single- or multi-organ metastases. NSCLC patients with metastasis to liver alone or in combination with other organs have a poorer prognosis

while isolated lung metastasis has the best outcomes.

关键词

Keywords

references

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