不同年龄组小细胞肺癌的临床特征与预后影响因素分析

doi:10.3969/j.issn.1006-5253.2022.04.002

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摘要目的分析不同年龄组小细胞肺癌患者的临床特征和预后影响因素，为改善患者预后状况提供参考依据。方法在SEER数据库中，筛选出符合条件的小细胞肺癌患者，利用 X-tile软件寻找出年龄截断值并根据年龄分组，组间临床特征比较采用χ²检验及秩和检验，生存曲线的差异采用时序检验，多因素Cox比例风险模型分析影响因素，并将有统计学意义的因素，用森林图进行可视化。结果纳入符合条件的小细胞肺癌患者共23 358例，根据 X-tile软件年龄分析结果共分为3组，分别是≤65岁，66~岁及≥80岁组。不同年龄组患者在性别、AJCC癌症分期、是否接受手术、是否放化疗、骨转移、脑转移、肺转移、肿瘤大小等方面，差异具有统计学意义(P<0.05)。对于<80岁的患者，人口学特征（种族、性别、家庭收入、保险、婚姻状况）、AJCC分期、治疗（手术、放疗、化疗）、转移（骨转移、脑转移、肝转移及肺转移）、肿瘤大小等对预后影响差异有统计学意义(P<0.05)；对于≥80岁的患者，AJCC分期、治疗（手术、放疗、化疗）、转移（脑转移、肝转移）、肿瘤大小对预后影响差异有统计学意义(P<0.05)，而人口学特征（种族、性别、家庭收入、婚姻状况）对预后影响差异无统计学意义(P>0.05)。结论不同年龄组小细胞肺癌患者的临床特征不全相同，预后影响因素也有差异。对于相对年轻的患者，人口学特征、AJCC分期、治疗、转移、肿瘤大小等是预后的主要影响因素；对于年龄大的患者，人口学特征不再是影响其预后的主要因素。建议对不同年龄的患者，针对主要影响因素采取不同的措施，改善其预后。

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	王蓉
	申洹浣
	谢书阳
	赵振军

关键词 ：小细胞肺癌, 临床特征, 预后, Cox比例风险模型

Abstract：Objective To analyze the clinical characteristics and prognostic factors of patients with small cell lung-cancer- in different age groups, and to provide reference for improving the prognostic status of patients.Methods In the SEER database, qualified small cell lung cancer patients were selected and divided into groups using X-tile software to find out the age cutoff value and group them according to age. Chi-square test and rank-sum test were used for the comparison of clinical characteristics between groups, time series test was used for the difference of survival curve, multivariate Cox proportional hazard model was used to analyze the influencing factors, and the forest plot was used to visualize the statistically significant factors.Results Totally 23 358 eligible small-cell lung cancer patients were included. According to the age analysis results of X-Tile software, they were divided into three groups: ≤65 years old, 66-years old and ≥80 years old. There were statistically significant differences in gender, AJCC cancer stage, surgery, radiotherapy and chemotherapy, bone metastasis, brain metastasis, lung metastasis and tumor size among patients of different age groups (P<0.05). Demographic characteristics (race, gender, family income, insurance, and marital status), AJCC stage, treatment (surgery, radiotherapy, and chemotherapy), metastasis (bone, brain, liver and lung metastasis), and tumor size had statistically significant difference in prognosis for those below 80 years old (P<0.05).AJCC stage, treatment (surgery, radiotherapy, and chemotherapy), metastasis (brain metastasis and liver metastasis), and tumor size had statistically significant difference in prognosis for those 80 years old and above (P<0.05), while demographic characteristics (race, gender, family income, and marital status) had no significant difference in prognosis (P>0.05).Conclusion The clinical characteristics of small cell lung cancer patients in different age groups are not all the same, and the prognostic factors are also different. Demographic characteristics, AJCC staging, treatment, metastasis and tumor size are the main influence factors of prognosis for relatively young patients; demographic characteristics are no longer the main factors that affect the prognosis for older patients. It is suggested that different measures should be taken to improve the prognosis of patients of different ages according to the main influencing factors.

Key words： small cell lung cancer clinical feature prognosis cox proportional hazard model

收稿日期: 2022-04-09

基金资助:国家自然科学基金（81772281）；山东省自然科学基金（ZR2019MH022，ZR2020KH015）

通讯作者: 赵振军，Email：zhaozhenjun@ytu.edu.cn

引用本文:

王蓉，申洹浣，谢书阳，赵振军. 不同年龄组小细胞肺癌的临床特征与预后影响因素分析[J]. 中国医院统计, 2022, 29(4): 246-252.
Wang Rong，Shen Huanhuan，Xie Shuyang，Zhao Zhenjun. Analysis of clinical features and prognostic factors of small cell lung-cancer-in different age groups. journal1, 2022, 29(4): 246-252.

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