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目的探讨晚期非小细胞肺癌一线化疗患者血浆纤维蛋白原状态与预后的相关性。方法回顾分析不同临床病理特征患者中化疗前纤维蛋白原状态,并进行生存分析。结果 236例患者中纤维蛋白原升高的发生率为56.6%,与病理类型、分期、吸烟史、性别、功能状态(PS)评分及年龄无明显关系。PS评分(HR=1.85,P<0.001)及纤维蛋白原升高(HR=1.63,P=0.008)为总生存的预后不良因素。化疗前纤维蛋白原正常和升高的患者其中位总生存期分别为20.8和15.1个月,两者比较差异有统计学意义(P=0.008);无疾病进展时间分别为8.5和5.5个月,两者比较差异无统计学意义(P=0.132)。结论化疗前血浆纤维蛋白原升高是晚期非小细胞肺癌一线化疗患者的预后不良因素,生存期明显缩短。监测纤维蛋白原状态不仅是预防患者出现血栓等凝血性疾病的有效措施,还可作为非小细胞肺癌发展、预后判断及辅助治疗的实验室指标。
Objective To investigate the correlation between plasma fibrinogen status and prognosis in first-line chemotherapy of advanced non-small cell lung cancer. Methods Retrospective analysis of patients with different clinical and pathological features of fibrinogen before chemotherapy and survival analysis. Results The incidence of fibrinogen in 236 patients was 56.6%, which was not related to the pathological type, staging, smoking history, gender, PS score and age. PS score (HR = 1.85, P <0.001) and fibrinogen (HR = 1.63, P = 0.008) were the poor prognostic factors for overall survival. The median overall survival of patients with normal and elevated fibrinogen before chemotherapy was 20.8 and 15.1 months, respectively, with significant differences between the two groups (P = 0.008). The progression-free time was 8.5 and 5.5 months, respectively, There was no significant difference between the two (P = 0.132). Conclusions The elevated plasma fibrinogen level before chemotherapy is an unfavorable prognostic factor for first-line chemotherapy in advanced non-small cell lung cancer with a significantly shortened survival. Monitoring fibrinogen status is not only an effective measure to prevent clotting diseases such as thrombosis in patients, but also as a laboratory index for the development of non-small cell lung cancer, prognosis and adjuvant therapy.