首页|凝血指标预测立体定向治疗NSCLC脑转移疗效

凝血指标预测立体定向治疗NSCLC脑转移疗效

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目的:分析凝血指标对非小细胞肺癌(non-small cell lung cancer,NSCLC)脑转移患者立体定向放射外科(stereotactic ra-dio surgery,SRS)治疗预后的预测价值.方法:回顾性收集 2015年 10月至 2018年 9月在天津市环湖医院确诊为NSCLC脑转移并行SRS治疗的 512例患者临床资料,分析总体生存(overall survival,OS)率与无进展生存(progression-free survival,PFS)率,运用Cox多因素分析影响预后相关因素,并基于Cox多因素分析绘制工作特征(receiver operating characteristic,ROC)曲线,运用曲线下面积(area under the ROC curve,AUC)分析凝血指标对NSCLC脑转移行SRS治疗患者预后的预测价值.结果:1、2、3、4年的PFS分别为79.9%、69.9%、56.6%、43.2%,OS分别为93.4%、83.2%、69.9%、57.6%.吸烟、纤维蛋白原(fibrinogen,Fib)<3.22 g/L、凝血酶原时间(prothrombin time,PT)<11.69 s、D-二聚体(D-dimer,D-D)<0.51 μg/L与较长的PFS率相关(P<0.05);活化部分凝血活酶时间(activated partial thromboplastin time,APTT)<21.05 s、Fib<3.22 g/L、D-D<0.51 μg/mL与较长的OS率相关(P<0.05).吸烟、Fib<3.22 g/L、D-D<0.51 μg/mL与较长的PFS率显著相关(P<0.05);Fib<3.22 g/L、D-D<0.51 μg/mL与较长的OS率显著相关(P<0.05).Fib与D-D联合检测预测NSCLC脑转移患者SRS治疗预后的AUC显著高于Fib与D-D单独检测(P<0.05).结论:凝血指标与SRS治疗的NSCLC脑转移患者预后有一定相关性,Fib与D-D为患者预后独立危险因素,可用于评估其预后,两组指标联合评估价值可能更优,具有进一步深入研究的价值.
Coagulation index predicts disease progression in patients with NSCLC and brain meta-stases after stereotactic radio surgery
Objective:To analyze the prognostic value of the coagulation index in stereotactic radio surgery(SRS)for patients with non-small cell lung cancer(NSCLC)and brain metastases(BMS).Methods:We retrospectively analyzed clinical data from 512 patients diagnosed with NSCLC and BMS,who were treated with SRS at Tianjin Huanhu Hospital from October 2015 to September 2018.The overall survival(OS)and progression-free survival(PFS)rates were analyzed.The Cox model was employed to examine prognostic factors.Subsequently,the receiver operating characteristic(ROC)curve was constructed based on multi-factor analysis usin the Cox model.The area under the ROC curve(AUC)was used to assess the prognostic value of coagulation indexes in patients with NSCLC and BMS who underwent SRS.Results:In 1,2,3,and 4 years,PFS rates were 79.9%,69.9%,56.6%,and 43.2%,respectively,and OS rates were 93.4%,83.2%,69.9%,and 57.6%,respectively.Smoking and average fibrinogen(Fib)levels,prothrombin time(PT),and D-dimer(D-D)levels were correlated with a longer PFS(P<0.05).Av-erage activated partial thromboplastin time(APTT),Fib,and D-D levels were correlated with a longer OS(P<0.05).Smoking and mean Fib and D-D levels were significantly correlated with a longer PFS(P<0.05),while The average levels of Fib and D-D are each significantly associated with longer OS rates(P<0.05).The combined detection of Fib and D-D in predicting the prognosis of NSCLC patients with brain metastases undergoing SRS treatment shows a significantly higher AUC compared to the detection of Fib and D-D individually(P<0.05).Conclusions:Co-agulation indexes have a certain correlation with the prognosis of patients with NSCLC and BMS treated with SRS.Furthermore Fib and D-D are independent risk factors for the prognosis of these patients and can be used to assess their outcomes.The combined evaluation of the indexes provides a more ideal prognostic assessment.

coagulation indexnon-small cell lung cancer(NSCLC)brain metastasesstereotactic radio surgery(SRS)prognostic value

刘颖、崔晓腾、王琴

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天津市环湖医院检验科(天津市 300222)

天津医科大学总医院,天津市神经病学研究所

凝血指标 非小细胞肺癌 脑转移 立体定向放射外科 预后价值

天津市卫生健康科技项目

TJWJ2021QN003

2024

中国肿瘤临床
中国抗癌协会

中国肿瘤临床

CSTPCD北大核心
影响因子:1.32
ISSN:1000-8179
年,卷(期):2024.51(10)