Effect of mu Agonists on Long-Term Survival and Recurrence in Nonsmall Cell Lung Cancer Patients.
Effect of mu Agonists on Long-Term Survival and Recurrence in Nonsmall Cell Lung Cancer Patients.
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DOI：
10.1097/md.0000000000001333
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发表时间：
2015-08
期刊：
影响因子：
1.6
通讯作者：
Du J
中科院分区：
文献类型：
--
作者：
Wang K;Qu X;Wang Y;Shen H;Liu Q;Du J
阿片类药物广泛用于术后镇痛。吗啡可能对细胞复制、迁移和癌症复发有影响。然而，术后μ受体激动剂与非小细胞肺癌（NSCLC）患者预后的相关性尚未得到充分研究。我们回顾性评价了术后μ受体激动剂对早期NSCLC患者总生存期（OS）和无病生存期（DFS）的影响。从山东省立医院生物库中选择患者及相关医疗信息。采用χ2检验分析术后mu受体激动剂组与未使用mu受体激动剂组的临床病理资料差异。进行单因素和多因素考克斯回归分析，并以风险比和95%置信区间形式表示。主要终点为OS，次要终点为DFS。这项回顾性研究纳入了2006年1月至2011年12月期间接受手术的984例连续NSCLC患者。术后使用μ受体激动剂组与未使用μ受体激动剂组除手术类型外，其他临床病理资料差异均无统计学意义（P = 0.041）。 在多变量考克斯回归模型中，术后mu受体激动剂的使用与较短的OS（HR 1.514，95% CI 1.197-1.916，P = 0.001）和较短的DFS（HR 1.415，95% CI 1.123-1.781，P =0.003）相关。 对于接受术后化疗或放疗的患者，术后μ受体激动剂也预测生存期较短（HR 1.437，95% CI 1.041-1.982，P = 0.027）。 亚组分析显示，术后给予mu受体激动剂与OS较短相关，尤其是在男性、吸烟较多、分化程度差、双叶切除术或肺切除术以及III期亚组中。对于接受手术的NSCLC患者，术后给予μ受体激动剂与较短的OS和DFS相关。
Opioids are widely used for postoperative analgesia. Morphine may have an effect on cell replication, migration, and cancer recurrence. However, the association of postoperative mu agonists with outcome of nonsmall cell lung cancer (NSCLC) patients has not been fully investigated. We retrospectively evaluated the impact of postoperative mu agonists on overall survival (OS) and disease-free survival (DFS) in early stage NSCLC patients. Patients and relevant medical information were selected from the Bio-Bank of Shandong Provincial Hospital. Difference of clinicopathologic information in postoperative mu agonists group and no mu agonists group was analyzed by χ2 test. Univariate and multivariate Cox regression analysis were conducted and represented as hazards ratio and 95% confidence interval form. The primary endpoint was OS and secondary endpoint was DFS. This retrospective study included 984 consecutive NSCLC patients who underwent surgery between January 2006 and December 2011. No significant difference existed between postoperative mu agonists usage group and no mu agonists usage group in clinicopathologic information except operation type (P = 0.041). Postoperative mu agonists usage was related to shorter OS (HR 1.514, 95% CI 1.197–1.916, P = 0.001) and shorter DFS (HR 1.415, 95% CI 1.123–1.781, P = 0.003) in the multivariate Cox regression model. For the patients who received postoperative chemotherapy or radiotherapy postoperative mu agonists also predict shorter survival (HR 1.437, 95% CI 1.041–1.982, P = 0.027). Subgroup analysis showed that administration of postoperative mu agonists was related to shorter OS, especially in males, more smoking, poor differential degree, bilobectomy or pneumonectomy, and stage III subgroup, respectively. Administration of postoperative mu agonists was related to shorter OS and DFS for the NSCLC patients who underwent surgery.