| 李鑫鑫.肺癌合并慢阻肺患者肿瘤根治术后生存预后的影响因素分析[J].浙江中西医结合杂志,2026,36(6): |
| 肺癌合并慢阻肺患者肿瘤根治术后生存预后的影响因素分析 |
| Analysis of influencing factors on survival and prognosis of patients with lung cancer complicated with COPD after radical tumor resection |
| 投稿时间：2025-05-01 修订日期：2025-08-18 |
| DOI： |
| 中文关键词: 慢性阻塞性肺疾病 肺癌 肺癌根治术 预后 影响因素 |
| 英文关键词:Chronic obstructive pulmonary disease Lung cancer Radical resection of lung cancer Prognosis Influencing factor |
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| 中文摘要: |
| 【】目的 ?探讨合并慢性阻塞性肺疾病(COPD)的肺癌患者在接受肺癌根治术后的预后影响因素。方法 ?选取我院2020年12月至2023年12月期间实施治疗根治性手术治疗的合并COPD的肺癌患者103例进行回顾性研究,根据患者3年生存结局将其分为生存组(n=67例)、死亡组(n=36例),对比两组患者的一般资料、肺癌病情资料、肺功能指标,采用Cox比例风险回归模型分析影响患者生存结局的因素。结果 死亡组患者的TNM分期(Ⅲ期)、发生淋巴结转移、发生埋管浸润的患者占比显著的高于生存组,差异均具有统计学意义(P<0.05)； 死亡组患者的显著的FEV1%pred、FVC%pred、FEV1/FVC、术前白蛋白测定值均显著低于生存组,差异具有统计学意义(P<0.05)；死亡组的GOLD分级中≥3级的COPD患者占比均显著高于生存组,差异均具有统计学意义(P<0.05)；Cox比例风险回归模型结果显示:TNM分期为Ⅲ期、发生淋巴结转移、发生脉管侵犯、术前血清白蛋白水平越低、GOLD分级≥3级是合并COPD的肺癌患者根治术后发生不良预后的危险因素(P<0.05)。结论?合并COPD的肺癌患者在接受肺癌根治术后预后结局受到TNM分期为Ⅲ期、发生淋巴结转移、发生脉管侵犯、术前血清白蛋白水平越低、GOLD分级≥3级的影响,其中肺功能越差,患者发生不良预后的风险越高。 |
| 英文摘要: |
| 【】Objective ?To investigate the prognostic factors of lung cancer patients complicated with chronic obstructive pulmonary disease (COPD) after radical lung cancer surgery. ?Methods ? A retrospective study was conducted on 103 patients with lung cancer complicated with COPD who underwent radical surgical treatment in our hospital from December 2020 to December 2023. According to the 3-year survival outcome of the patients, they were divided into survival group (n=67 cases) and death group (n=36 cases), and the general data, lung cancer disease data and lung function indexes of the two groups were compared. Cox proportional risk regression model was used to analyze the factors affecting the survival outcome of patients. Results? The proportion of TNM stage (stage III), lymph node metastasis and embedding canal infiltration in death group was significantly higher than that in survival group, with statistical significance (P<0.05). The significant values of FEV1%pred, FVC%pred, FEV1/FVC and preoperative albumin in death group were significantly lower than those in survival group, with statistical significance (P<0.05). The proportion of COPD patients with GOLD grade ≥3 in the death group was significantly higher than that in the survival group, with statistical significance (P<0.05). Cox proportional risk regression model showed that TNM stage Ⅲ, lymph node metastasis, vascular invasion, lower preoperative serum albumin level, and GOLD grade ≥3 were risk factors for poor prognosis after radical surgery in patients with COPD (P<0.05). ?Conclusion ?The outcome of lung cancer patients with COPD is affected by TNM stage, lymph node metastasis, vascular invasion, lower preoperative serum albumin level, and GOLD grade 3, in which the worse the lung function, the higher the risk of poor prognosis. |
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