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1、-新疆医科大学硕士学位论文局部晚期非小细胞肺癌放化疗后复发的相关因素分析研究生:韩潇导师:张莉副教授摘要目的:探讨局部晚期非小细胞肺癌放化疗后出现局部复发及远处转移的临床相关因素,为有效控制复发及转移提供临床依据。方法:回顾性分析我院260例经病理明确诊断,行化疗或放化疗联合治疗的局部晚期非小细胞肺癌患者的临床资料及与复发有关的相关因素。结果:1.260例局部晚期肺癌患者中有219例出现复发(局部复发及远处转移),占84.23%(219/260),其中89例为局部复发,占34.23%(89/260);130例为远处转移,占65.77%(130/260
2、);2.单因素分析显示临床资料中中:CEA水平、贫血、临床分期、T分期、N分期、治疗方式、近期疗效、血小板水平与复发有关(P<0.05);3.多因素分析示:CEA升高、贫血、血小板数增多、晚的临床分期是肺癌复发的重要危险因素(P<0.2,OR值>1),而且CEA升高、血小板数升高、晚的临床分期是肺癌远处转移的重要危险因素(P<0.2,OR值>1);化疗的周期数、近期疗效、放化疗联合治疗是肺癌复发的保护因素(P<0.2,OR值<1);尤其是化疗的周期数是肺癌远处转移的保护因素(P<0.2,OR值<1)。结论:局部晚期的非小细胞肺癌患者治疗后绝大数出现复
3、发,临床病理相关因素中,保护因素有化疗的周期数、近期疗效、放化疗联合治疗;促使肺癌复发的相关因素有CEA水平升高、贫血、血小板数增高、晚的临床分期。关键词:非小细胞肺癌;复发;转移;1---新疆医科大学硕士学位论文Locallyadvancednon-smallcelllungcancerrecurrenceafterradiotherapyandchemotherapyrelatedfactorsPostgraduate:HanXiaoSupervisor:AssociateProf.ZhangLiAbstractObjective:Tostudy
4、locallyadvancednon-smallcelllungcancerafterradiotherapyandchemotherapyhadlocalrecurrenceanddistantmetastasisofclinicopathologicfactors.Methods:Aretrospectiveanalysisof260casesinourhospitalanddiagnosedbypathologychemotherapyorchemotherapycombinedtreatmentforlocallyadvancednon-sm
5、allcelllungcancerpatientswithrecurrenceofclinicaldataandrelatedfactors.Results:1.Thisgroupof260patientswithlocallyadvancedlungcancerrecurrencein219cases(localrecurrenceanddistantmetastasis),accountingfor84.23%(219/260),ofwhich89patientswithlocalrecurrence,accountingfor34.23%(89
6、/260);130patientswithdistantmetastasis,accountingfor65.77%(130/260);2.Univariateanalysisshowedthatclinicalandpathologicaldata:CEA,anemia,clinicalstage,Tstage,Nstage,treatment,curativeeffect,plateletlevelsandrecurrence(P<0.05);3.Multivariateanalysisshowedthat:ahighCEAlevel,anemi
7、a,thrombocytopenia,elevatedlevelsofclinicalstageisanimportantriskfactoroflungcancerrecurrence(P<0.2,ORvalues>1),butthehighCEA,plateletlevels,lateclinicalstageoflungcancerriskfactorofdistantmetastasis(P<0.2,ORvalues>1);numberofcyclesofchemotherapy,curativeeffect,chemotherapycomb
8、inedtreatmentprotectivefactorforlungcancerrecurrence(P