Advanced pneumonic type of lung adenocarcinoma: survival predictors and treatment efficacy of the tumor
Advanced pneumonic type of lung adenocarcinoma: survival predictors and treatment efficacy of the tumor
复制标题
晚期肺炎型肺腺癌：肿瘤的生存预测因素和治疗效果
DOI：
10.1177/0300891620947159
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发表时间：
2020-08-06
期刊：
影响因子：
1.9
通讯作者：
Zhou, Min
中科院分区：
文献类型：
--
作者：
Zong, Qiu;Zhu, Feng;Zhou, Min
目的：回顾性分析晚期肺型肺腺癌（P-ADC）的预后因素及治疗效果。研究方法：回顾性分析2009年1月1日至2019年4月30日期间41例晚期P-ADC患者的临床数据和生存随访。对癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）和细胞角蛋白-19片段（Cyfra 21 -1）等肿瘤生物标志物进行了分析。本研究中的患者根据酪氨酸激酶抑制剂（TKI）的使用情况分为三组：TKI治疗组（包括联合化疗）、非TKI治疗组（单独化疗）和姑息治疗组。结果如下：半数以上的患者肿瘤标志物水平较高，NSE的发生率最高（81.8%），其次是CEA（74.4%）和Cyfra 21 -1（74.1%）。所有患者的胸部计算机断层扫描均异常，病理为腺癌。TKI组的总生存期（OS）为10.4个月，非TKI组为8.8个月，姑息治疗组为2.1个月。血清Cyfra 21 -1水平较高的患者与Cyfra 21 -1正常的患者相比，生存时间无显著缩短（p= 0.067）。与姑息治疗相比，TKI治疗和非TKI治疗提供了更好的预后预测。与非TKI治疗相比，TKI治疗改善了预后。与非TKI治疗相比，基于TKI的综合治疗改善了OS。结论：TKI为主的综合治疗可改善晚期P-ADC的预后和OS。本研究建议对所有晚期P-ADC患者进行EGFR突变分析。
Purpose: To retrospectively explore the survival predictors and treatment efficacy of advanced pneumonic-type lung adenocarcinoma (P-ADC). Methods: Retrospective analysis of clinical data and survival follow-up was undertaken on 41 patients with advanced P-ADC from January 1, 2009, to April 30, 2019. Analysis on tumor biomarkers such as carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), and the cytokeratin-19-fragment (Cyfra21-1) were undertaken. The patients in this study were divided into three groups based on usage of tyrosine kinase inhibitor (TKI): TKI therapy group (including combination with chemotherapy), non-TKI therapy group (chemotherapy alone), and palliative care group. Results: More than half of the patients had higher levels of tumor biomarkers and the incidence of NSE was highest (81.8%), followed by CEA (74.4%) and Cyfra21-1 (74.1%). All patients had abnormal findings on chest computed tomography and with adenocarcinoma pathology. The overall survival (OS) time was 10.4 months in TKI group, 8.8 months in the non-TKI group, and 2.1 months in the palliative care group. Patients with higher level of serum Cyfra21-1 had insignificantly shorter survival time compared to those with normal Cyfra21-1 (p= 0.067). TKI therapy and non-TKI therapy provided a better prognosis prediction compared to palliative care. TKI therapy improved prognosis compared to non-TKI therapy. The comprehensive based TKI therapy provided improved OS vs the non-TKI therapy. Conclusion: TKI-based therapy could improve the prognosis and OS for advanced P-ADC. This study recommends the analysis ofEGFRmutations for all patients with advanced P-ADC.