摘要
目的探讨肺癌中枢神经系统(CNS)转移患者的生存期,血管内皮细胞生长因子(VEGF)的水平以及影响预后的因素。方法分析2017年1月至2022年10月在河北医科大学第二医院神经内科确诊的肺癌CNS转移患者的临床资料。根据Kaplan-Meier法进行生存分析,并用Log-Rank检验进行生存率的显著性比较,采用Cox比例风险回归模型研究多因素对生存时间的影响。结果纳入肺癌CNS转移患者133例,中位总生存期(OS)为11.2个月。肺癌CNS患者中脑脊液(CSF)VEGF较血清VEGF(185.4 pg·mL^(-1)vs.21.2 pg·mL^(-1))升高,差异有统计学意义(P<0.001)。在肺癌CNS转移患者的CSF中有49.6%(66/133)检测出表皮生长因子受体(EGFR)突变。在进行单因素生存预后禾哆因素Cox回归分析时,脑膜转移(HR=4.78,95%CI 1.93~11.97,P=0.001)、靶向治疗(HR=0.57,95%CI 0.37~0.88,P=0.01)、联合治疗(HR=0.61,95%CI 0.40~0.95,P=0.029)是影响肺癌CNS预后的因素,差异均有统计学意义。结论肺癌CNS转移患者临床预后差,且EGFR突变患者占有很大比例。肺癌CNS患者CSF中VEGF水平较血清中VEGF高,为我们应用抗血管生成药物治疗CNS转移奠定基础。脑膜转移是肺癌CNS转移不良预后不良的因素,靶向治疗、联合治疗是肺癌CNS转移预后良好的因素。
Objective To investigate the survival time,the level of VEGF prognostic factors of patients with CNS metastasis of lung cancer.Methods We retrospectively analyzed the clinical data of patients with CNS metastasis of lung cancer in our hospital from January 2017 to October 2022.Survival analysis was conducted according to Kaplan-Meier method,and the significance of survival rates was compared by Log-Rank test.Cox proportional risk regression model was used to study the influence of multiple factors on survival time.Results A total of 133 lung cancer patients CNS metastases were included in this study and the median overall survival(OS)was 11.2 months.The level of vascular endothelial growth factor(VEGF)in the CSF of patients with lung cancer was higher than that in the serum(185.4 pg·mL^(-1) vs.21.2 pg·mL^(-1)),the difference was statistically significant(P<0.001).Mutations of the epidermal growth factor receptor(EGFR)were detected in the CSF of 49.6%(66/133)of patients.In univariate survival and multivariate Cox regression analysis.LM(HR=4.78,95%CI 1.93-11.97,P=0.001),targeted therapy(HR=0.57,95%CI 0.37-0.88,P=0.01)and combined therapy(HR=0.61,95%CI 0.40-0.95,P=0.029)were all independent prognostic factors.Conclusion Patients with CNS metastasis of lung cancer have poor clinical prognosis and a large proportion of patients with EGFR mutation.The level of CSF VEGF in patients with CNS lung cancer is higher than that in serum,which lays a foundation for the treatment of CNS metastasis with antiangiogenic drugs.LM is a factor for poor prognosis.Targeted therapy and combined therapy are factors for good prognosis.
作者
齐雪姣
白凯旋
赵银龙
刘澜
何俊瑛
卜晖
Qi Xuejiao;Bai Kaixuan;Zhao Yinlong;Liu Lan;He Junying;Bu Hui(Department of Neurology,the Second Hospital of Hebei Medical University,Key of Laboratory of Clinical Neurology,Ministry of Education,Hebei Medical University,Hebei Key Laboratory of Neurdgy,Shijiazhuang 050000,China)
出处
《脑与神经疾病杂志》
2025年第9期543-548,共6页
Journal of Brain and Nervous Diseases
基金
中央引导地方科技发展资金项目(236Z7753G)
河北省卫生健康委科研基金项目(20221013)。
关键词
肺癌
中枢神经系统转移
治疗
生存期
预后
Lung cancer
Central nervous system metastasis
Treatment
Survival
Prognosis
