年轻患者的肺癌与更先进的疾病有关,但整体生存率更好
Gianna Dingillo1, Aria Bassiri2, Avanti Badrinathan2
1Case Western Reserve University School of Medicine, Cleveland, Ohio.
The Journal of surgical research
|September 8, 2023
概括
与老年人相比,患有非小细胞肺癌 (NSCLC) 的年轻患者 (≤50) 患有更晚期的疾病,但总体存活率 (OS) 较好. 这凸显了在年轻人群中提高对NSCLC的认识的必要性.
科学领域:
- 在瘤学瘤学.
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 年龄与非小细胞肺癌 (NSCLC) 的攻击性和生存结果之间的关系仍然不完全理解.
- 较年轻的患者群体通常被认为患有NSCLC的侵袭性形式的风险较低,可能导致诊断延迟或低估疾病严重程度.
研究的目的:
- 研究年轻年龄与疾病呈现,特别是晚期和结节转移在非小细胞肺癌 (NSCLC) 之间的关联.
- 为了评估年轻患者诊断出NSCLC的整体生存 (OS) 结果,与老年人相比.
主要方法:
- 利用国家癌症数据库 (NCDB) 在2004年至2018年期间识别了1,651,744名NSCLC患者.
- 将患者分为三个年龄组:≤50岁,51-84岁和≥85岁.
- 采用多变量逻辑回归来分析年龄与IV期NSCLC和淋巴结阳性的关联,以及多变量Cox和Kaplan-Meier分析整体存活率 (OS).
主要成果:
- 与51-84岁的年龄组相比,年龄≤50岁的患者更有可能出现第四阶段NSCLC (OR 1.17) 和临床淋巴结阳性 (OR 1.27) .
- 尽管出现更晚期的疾病,但50岁以下的年龄组在所有阶段 (I阶段HR0.61,II阶段HR1.12,III阶段HR2.12,IV阶段HR6.65) 的总生存率都比51-84岁的年龄组更好.
- 最年长的组 (≥85岁) 也显示出与第四阶段NSCLC (OR 1.03) 的几率增加的关联.
结论:
- 诊断为NSCLC的年轻患者 (≤50岁) 在呈现时表现出更高的晚期疾病发病率,但与中年患者 (51-84岁) 相比,同时体验出更高的整体存活率.
- 这些发现强调了提高临床意识和针对年轻人进行NSCLC的量身定制查或诊断方法的关键需求,这些人可能不符合传统的高风险概况.
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