非小细胞肺癌脑转移患者临床特征及预后影响因素分析

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Abstract Objective To explore the clinical characteristics and prognostic factors in patients of non-small cell lung cancer with brain metastasis. Methods A total of 9411 patients with organ metastasis of non-small cell lung cancer from January 2000 to January 2005 were collected by SEER*stat software. The clinical characteristics of 4299 patients with brain metastasis and 5112 patients without brain metastasis were compared by chi-square test and binary logistic regression. Kaplan-Meier method was used to analyze the clinical and pathological characteristics that possible influencing factors of brain metastasis. Log-Rank method was used to test the difference of survival rate. Multivariate Cox regression model was used to analyze the independent risk factors that affect the long-term prognosis of non-small cell lung cancer patients with brain metastasis. The Nomogram figure was constructed by R software version 3.4.4 using independent risk factors affecting long-term prognosis, and the predictive value of the model was evaluated by calculating the consistency index (C-index). Results The results of binary logistic regression showed that age (OR=1.284, 95%CI：1.243-1.326, P ＜ 0.001), gender (OR=0.785, 95%CI：0.731-0.843, P ＜ 0.001), pathological type (OR=0.622, 95%CI：0.575-0.673, P ＜ 0.001), N stage (OR=1.094, 95%CI：1.058-1.131, P ＜ 0.001) were independent risk factors for brain metastasis. The results of multivariate Cox regression showed that age (HR=1.25, 95%CI：1.210-1.290, P ＜ 0.001), race (HR=0.865, 95%CI：0.823-0.909, P ＜ 0.001), gender (HR=0.827, 95%CI：0.774-0.884, P ＜ 0.001), histological grade (HR=1.198, 95%CI：1.133-1.267, P ＜ 0.001), pathological type (HR=0.740, 95%CI：0.682-0.803, P ＜ 0.001), Tumor stage (HR=1.078, 95%CI：1.054-1.104, P ＜ 0.001), N stage (HR=1.078, 95%CI：1.044-1.114, P ＜ 0.001), bone metastasis (HR=0.917, 95%CI：0.850-0.989, P < 0.05), liver metastasis (HR=0.742,95%CI：0.673-0.819, P ＜ 0.001) were independent prognostic factors of non-small cell lung cancer patients with brain metastasis. The C-index was calculated as 0.643. Conclusion The incidence of brain metastasis is higher in young women, adenocarcinoma and patients with early N stage. The prognosis of elderly white male patients with high histological grade, squamous cell carcinoma, late Tumor stage and N stage, bone metastasis and liver metastasis is poor. The clinical model has a medium predictive value.

Key words： Non-small cell lung cancer Brain metastasis Predictive factors Survival analysis SEER database

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	YANG Siqi1 YAO Yi1
	2 SONG Qibin1
	2▲

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YANG Siqi1 YAO Yi1,2 SONG Qibin1,2▲. Analysis of clinical characteristics and prognostic factors in patients with non-small cell lung cancer with brain metastasis[J]. 中国医药导报, 2020, 17(32): 4-8,16.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I32/4

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