Prognostic effects of preoperative obstructive pneumonitis or atelectasis and comparison with tumor size in non-small cell lung cancer
作者
Pang, ZF;Ding, N;Dong, W;Ni, Y;Zhang, TH;Qu, X;Du, JJ;Liu, Q
作者单位
[Pang, Zhaofei; Ding, Nan; Qu, Xiao; Du, Jiajun; Liu, Qi] Shandong Univ, Inst Oncol, Shandong Prov Hosp, Jinan 250021, Peoples R China.;-;[Dong, Wei; Du, Jiajun] Shandong Univ, Dept Thorac Surg, Shandong Prov Hosp, Jinan 250021, Peoples R China.;-;[Ni, Yang; Zhang, Tiehong] Shandong Univ, Dept Oncol, Shandong Prov Hosp, Jinan 250021, Peoples R China.
摘要
Background: In the eighth TNM staging system proposal, lung cancer with part or complete obstructive pneumonitis/atelectasis was classified to T2 category, and dividing lines of T category were changed. We conducted this study to search prognostic effect of preoperative obstructive pneumonitis/atelectasis and its comparison with tumor size.;-;Methods: We collected clinical characteristics, preoperative hematological indicators, follow-up information of 1,313 lung cancer patients. Chi-square test was used to search relationship between obstruction pneumonitis/atelectasis and other factors. Kaplan-Meier (K-M) curves and cox regression methods were used for survival analysis.;-;Results: Preoperative obstructive pneumonitis/atelectasis indicated shorter OS (HR: 1.308; 95% CI: 1.058-1.619) and RFS (HR: 1.276; 95% CI: 1.032-1.579) as an independent factor. In comparison with tumor size, we found patients with obstructive pneumonitis/atelectasis and T1 size tumor had similar prognosis to those with T2 size but without obstructive pneumonitis/atelectasis, and OS, RFS of patients with obstructive pneumonitis/atelectasis and T2 size were significantly shorter than those with T2 tumor size but without obstructive pneumonitis/atelectasis, while similar to patients with T3 tumor size but without obstructive pneumonitis/atelectasis according to division by the eighth edition. We also found obstructive pneumonitis/atelectasis was significantly related to higher neutrophil (P<0.001), platelet (P<0.001), monocyte (P<0.001), NLR (P<0.001), PLR (P=0.002), ESR (P<0.001) and lower LMR (P<0.001).;-;Conclusions: Preoperative obstructive pneumonitis/atelectasis predicted poor survival independently in non-small cell lung cancer (NSCLC). And we suggested which T staging group the patients with obstructive pneumonitis/atelectasis would be divided to should depend on tumor size in the eighth TNM staging system.
关键词
LYMPHOCYTE RATIO; INFLAMMATION; MACROPHAGES; STATISTICS; SURVIVAL