[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.目的： 探讨晚期肺癌患者的贫血情况及其与临床病理特征和预后的关系。 方法： 回顾性分析741例Ⅲ~Ⅳ期肺癌患者的临床资料，分析肺癌自然病程中贫血的发生率和贫血类型，分析贫血与患者的性别、年龄、病程时间、临床分期和预后营养指数(PNI)的关系。采用Kaplan－Meier法和多因素Cox回归模型分析贫血对患者预后的影响。 结果： 741例患者中，无贫血334例(45.1%)，贫血407例(54.9%)。407例贫血患者的血红蛋白为(89.39±15.76)g/L，其中轻度贫血214例(52.6%)，中度贫血173例(42.5%)，重度贫血20例(4.9%)。慢性病贫血最多，占79.6%(324/407)；其次为缺铁性贫血，占4.2%(17/407)。贫血发生与患者的性别和年龄均无关(均P>0.05)；贫血发生与患者的病程、临床分期和PNI均有关(均P<0.05)。贫血程度与患者的性别和年龄均无关(均P>0.05)；贫血程度与患者的病程、临床分期和PNI均有关(均P<0.05)。伴贫血患者的中位生存时间为10.5个月(95% CI为10.1~10.9个月)，无贫血患者的中位生存时间为13.0个月(95% CI为12.2~13.8个月)，差异有统计学意义(P<0.001)。轻度贫血患者的中位生存时间为11.0个月(95% CI为10.7~11.3个月)，中重度贫血患者的中位生存时间9.6个月(95% CI为9.1~10.1个月)，差异有统计学意义(P=0.048)。Cox回归生存分析显示，贫血发生和贫血程度均为肺癌患者预后的独立影响因素(均P<0.05)。 结论： 晚期肺癌患者自然病程中贫血发生率高，以慢性病贫血为主。贫血的发生发展与病程、临床分期和PNI密切相关。贫血发生和贫血程度均为肺癌患者预后的独立影响因素。.