[Relationship between anemia and clinical features and prognosis of advanced lung cancer patients]

Objective: To investigate the relationship of anemia and clinicopathological features and prognosis of patients with advanced lung cancer. Methods: The clinical data of 741 patients with stage Ⅲ~Ⅳ lung cancer were collected and analyzed retrospectively. We analyzed the incidence and type of anemia during the natural course of lung cancer patients, and its relationship with the gender, age, duration of disease, clinical stage, prognostic nutritional index (PNI) of these patients. Kaplan-Meier method and multivariate Cox regression model were used to analyze the effect of anemia on prognosis. Results: Among 741 cases of lung cancer patients, 407 (54.9%) cases were accompanied with anemia, whose hemoglobin (Hb) was (89.39±15.76) g/L, including 214 cases of mild anemia, 173 cases of moderate anemia and 20 cases of severe anemia. The most common type of anemia is anemia of chronic disease (ACD), the incidence rate of which was 79.6% (324/407), followed by the iron deficiency anemia (IDA), the incidence rate of which was 4.2% (17/407). The incidence of anemia was marginally related to the gender and age (P>0.05), but significantly related to the duration of disease, clinical stage and PNI (all P<0.05). The degree of anemia was marginally related to the gender and age (P>0.05), but significantly related to the duration of disease, clinical stage and PNI (all P<0.05). The median survival time of the patients with anemia was 10.5 months (95% CI: 10.1~10.9 ), significantly shorter than 13.0 months (95% CI: 12.2~13.8) of patients without anemia (P<0.001). The median survival time of mild anemia patients was 11.0 months (95% CI: 10.7~11.3), significantly longer than 9.6 months (95% CI: 9.1~10.1) of moderate and severe anemia patients (P=0.048). The results of Cox regression survival analysis showed that the incidence and degree of anemia were independent factors of prognosis of patients with lung cancer (P<0.05). Conclusions: During the natural course of advanced lung cancer, the incidence of anemia is high, especially ACD. The incidence and degree of anemia are substantially correlated with the duration of disease, clinical stage and PNI. The incidence and degree of anemia are independent prognostic factors of patients with lung cancer.