2022 年第 10 期 第 17 卷

微波消融治疗老年非小细胞肺癌合并重度慢性阻塞性肺疾病预后的影响因素分析

Prognostic factors of elderly non-small cell lung cancer patients with severe chronic obstructive pulmonary disease treated by microwave ablation

作者：靳智勇孙嘉阳鲁志刚郭占林

英文作者：Jin Zhiyong Sun Jiayang Lu Zhigang Guo Zhanlin

单位：内蒙古医科大学附属医院胸外科，呼和浩特010050

英文单位：Department of Thoracic Surgery the Affiliated Hospital of Inner Mongolia Medical University Hohhot 010050 China

关键词：非小细胞肺癌；慢性阻塞性肺疾病；微波消融术；影响因素

英文关键词：Non-smallcelllungcancer;Chronicobstructivepulmonarydisease;Microwaveablation; Influencefactors

• 摘要：

• 目的 探讨老年非小细胞肺癌合并重度慢性阻塞性肺疾病（COPD）患者应用微波消融术治疗预后的影响因素。方法 收集2018年3月至2020年3月于内蒙古医科大学附属医院诊治的131例老年非小细胞肺癌合并重度COPD患者的临床资料行回顾性分析，均行微波消融术治疗。随访至2020年12月31日，统计患者生存期。根据生存情况分为生存组和死亡组，比较2组临床和病理资料。采用多因素Logistic回归方法分析影响患者预后的危险因素。结果 所有患者均完成随访，随访时间8～27个月、中位时间11个月。生存组45例（生存期7.8~14.3个月、中位时间10.0个月）、死亡组86例。死亡组长期吸烟史、呼吸衰竭、肿瘤分期Ⅲ～Ⅳ期、未放疗、未化疗和Karnofsky评分≤70分的比例均高于生存组，差异均有统计学意义（均P<0.05）。多因素Logistic回归分析结果显示，长期吸烟史、合并呼吸衰竭、肿瘤分期Ⅲ～Ⅳ期、未放疗、未化疗和Karnofsky评分较低为影响老年非小细胞肺癌合并重度COPD患者微波消融治疗预后的独立危险因素（均P<0.05）。结论 长期吸烟史、合并呼吸衰竭、肿瘤分期Ⅲ～Ⅳ期、未行放化疗和Karnofsky评分较低的老年非小细胞肺癌合并重度COPD患者微波消融术后预后较差。

• Objective  To investigate the prognostic factors of microwave ablation in elderly patients with non-small cell lung cancer complicated with severe chronic obstructive pulmonary disease(COPD). Methods The clinical data of 131 elderly patients with non-small cell lung cancer complicated with severe COPD admitted to the Affiliated Hospital of Inner Mongolia Medical University from March 2018 to March 2020 were collected and analyzed retrospctively. Patients were treated with microwave ablation. Followed-up to December 31, 2020, the average overall survival time of patients was counted. According to the survival condition, they were divided into survival group and death group, and the clinical and pathological data of the two groups were compared. Multivariate Logistic regression analysis was used to analyze the risk factors affecting the prognosis of patients. Results All patients were followed-up for 8-27 months, with a median of 11 months. There were 45 cases in survival group (the survival time was 7.8-14.3 months, with a median of 10.0 months) and 86 cases in death group. The proportions of long-term smoking history, respiratory failure, tumor stage Ⅲ-Ⅳ, no radiotherapy, no chemotherapy and Karnofsky score≤70 in the death group were higher than those in the survival group(all P<0.05). Multivariate Logistic regression analysis showed that long-term smoking history, combined with respiratory failure, tumor stage Ⅲ-Ⅳ, no radiotherapy, no chemotherapy and low Karnofsky score were independent risk factors affecting the prognosis of elderly non-small cell lung cancer complicated with severe COPD after microwave ablation (all P<0.05). Conclusion The prognosis of elderly patients with non-small cell lung cancer complicated with severe COPD after microwave ablation is poor with long-term smoking history, respiratory failure, tumor stage Ⅲ-Ⅳ, no radiotherapy, no chemotherapy and low Karnofsky score.