引用本文:郝云霞,高绍英,辛林泽,许 耀.血浆氨基末端脑钠肽前体水平对晚期非小细胞肺癌患者预后的影响[J].中国临床新医学,2022,15(3):238-242.
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血浆氨基末端脑钠肽前体水平对晚期非小细胞肺癌患者预后的影响
郝云霞,高绍英,辛林泽,许 耀
265200 山东,烟台市莱阳中心医院肿瘤内科(郝云霞,高绍英),心血管内科(辛林泽,许 耀)
摘要:
[摘要] 目的 探讨血浆氨基末端脑钠肽前体(NT-proBNP)水平对晚期非小细胞肺癌(NSCLC)患者预后的影响。方法 回顾性收集2013年1月至2016年6月在烟台市莱阳中心医院收治的128例晚期NSCLC患者的临床资料。采用Kaplan-Meier法绘制患者生存曲线,比较不同分层下患者的生存预后[NT-proBNP>654.5 ng/L组 vs NT-proBNP≤654.5 ng/L组;Cyfra21-1>3.5 μg/L组 vs Cyfra21-1≤3.5 μg/L组;ⅢB期组 vs Ⅳ期组;慢性阻塞性肺疾病(COPD)组 vs 非COPD组;胸腔积液组 vs 非胸腔积液组]。采用Cox回归分析探讨影响晚期NSCLC患者生存预后的风险因素。比较NT-proBNP>654.5 ng/L组和NT-proBNP≤654.5 ng/L组的临床资料。结果 本研究晚期NSCLC患者的5年总体生存率为7.81%。Kaplan-Meier生存曲线分析结果显示,NT-proBNP>654.5 ng/L、Cyfra21-1>3.5 μg/L、IASLC分期为Ⅳ期,以及合并COPD、胸腔积液的NSCLC患者的生存预后更差(P<0.05)。Cox回归分析结果显示,病理类型为腺癌(HR=1.872)、国际肺癌研究协会(IASLC)分期为Ⅳ期(HR=2.910),以及较高的NT-proBNP水平(HR=1.945)是影响NSCLC患者生存预后的独立危险因素(P<0.05)。与NT-proBNP≤654.5 ng/L组比较,NT-proBNP>654.5 ng/L组的体质量指数(BMI)、三酰甘油和血肌酐水平更高,差异有统计学意义(P<0.05)。结论 较高的NT-proBNP水平可能是影响晚期NSCLC患者生存预后的独立风险因素,值得临床医师关注。
关键词:  非小细胞肺癌  氨基末端脑钠肽前体  生存预后
DOI:10.3969/j.issn.1674-3806.2022.03.11
分类号:R 734.2
基金项目:烟台市科技创新发展计划项目(编号:2021YD093)
Effect of plasma amino-terminal pro-brain natriuretic peptide levels on prognosis of patients with advanced non-small cell lung cancer
HAO Yun-xia, GAO Shao-ying, XIN Lin-ze, et al.
Department of Internal Medicine-Oncology, Laiyang Central Hospital of Yantai City, Shandong 265200, China
Abstract:
[Abstract] Objective To investigate the effect of plasma amino-terminal pro-brain natriuretic peptide(NT-proBNP) levels on the prognosis of patients with advanced non-small cell lung cancer(NSCLC). Methods The clinical data of 128 patients with advanced NSCLC who were admitted to Laiyang Central Hospital of Yantai City from January 2013 to June 2016 were retrospectively collected. The survival curve of the patients was plotted by Kaplan-Meier method, and the survival prognoses of the patients under different stratifications were compared[the NT-proBNP>654.5 ng/L group vs the NT-proBNP≤654.5 ng/L group; the Cyfra21-1>3.5 μg/L group vs the Cyfra21-1≤3.5 μg/L group; the stage ⅢB group vs the stage Ⅳ group; the chronic obstructive pulmonary disease(COPD) group vs the non-COPD group; the pleural effusion group vs the non-pleural effusion group]. Cox regression analysis was used to explore the risk factors affecting the survival and prognosis of the patients with advanced NSCLC. The clinical data were compared between the NT-proBNP>654.5 ng/L group and the NT-proBNP≤654.5 ng/L group. Results The 5-year overall survival rate of the patients with advanced NSCLC in this study was 7.81%. The results of Kaplan-Meier survival curve analysis showed that the NSCLC patients with NT-proBNP>654.5 ng/L, the NSCLC patients with Cyfra21-1>3.5 μg/L, the NSCLC patients with International Association for the Study of Lung Cancer(IASLC) stage Ⅳ, the NSCLC patients complicated with COPD and the NSCLC patients complicated with pleural effusion had worse survival prognosis(P<0.05). The results of Cox regression analysis showed that the pathological type of adenocarcinoma(HR=1.872), IASLC stage Ⅳ(HR=2.910), and higher NT-proBNP level(HR=1.945) were the independent risk factors affecting the survival and prognosis of the NSCLC patients(P<0.05). Compared with the NT-proBNP≤654.5 ng/L group, the NT-proBNP>654.5 ng/L group had higher body mass index(BMI), triglyceride and serum creatinine levels, and the differences were statistically significant(P<0.05). Conclusion Higher NT-proBNP levels may be an independent risk factor affecting the survival and prognosis of patients with advanced NSCLC, which deserves the attention of clinicians.
Key words:  Non-small cell lung cancer(NSCLC)  Amino-terminal pro-brain natriuretic peptide(NT-proBNP)  Survival prognosis