非小细胞肺癌恶性胸腔积液的临床特征及预后影响因素

目的 研究非小细胞肺癌（NSCLC）恶性胸腔积液患者的临床特征及影响疗效、预后的因素。方法 选择安徽省胸科医院2013年1月至2014年12月收治的91例伴恶性胸腔积液NSCLC患者，回顾分析患者临床资料、胸腔积液情况、胸腔积液治疗情况等，分析各因素对疗效及生存期的影响。结果 血性胸水患者RR为48.7%，显著低于非血性胸水患者（P<0.05）；胸腔局部应用IL-2生物治疗RR为70.3%，显著高于不用IL-2进行局部治疗者（P<0.05）。非血性胸水中位生存期位13个月，较血性胸水生存有优势，胸腔局部应用含IL-2生物治疗中位生存期为12个月，较不用IL-2治疗生存有优势，在腺癌患者中EGFR-TKI联合化疗生存优于单纯化疗，而后者生存优于单纯EGFR-TKI治疗（P<0.05）。结论 血性胸水疗效及预后差，胸腔局部应用IL-2生物治疗疗效较好、生存有优势。

Clinical characteristics and prognostic factors in non-small cell lung cancer with malignant pleural effusion

Objective To investigate the clinical characteristics and curative effect,prognostic factors in non-small cell lung cancer (NSCLC) with malignant pleural effusion(MPE).Methods The data of 91 patients with malignant pleural effusion in non-small cell lung cancer were collected, including the patients''general clinical data(sex,age,histological type,the onset of tumor staging, the time of MPE,other effusion,and bilateral pleural effusion), details of pleural effusion(whether it was congestive pleural effusion,number of the effusion cells,LDH,CEA, and cytopathology of pleural effusion)and treatments of pleural effusion,and the factors which influenced pleural effusion control and survival time under the above conditions were analyzed.Results RR in congestive pleural effusion patients was 48.7%,which was significantly lower than that of non congestive patients with pleural effusion.The RR was 70.3% in local application of IL-2 chest biological treatment,significantly higher than that without the IL-2 biological treatment.The median overall survival of non congestive pleural effusion patients was 13 months,and that of local application of IL-2 chest biological treatment was 12 months.Adenocarcinoma of EGFR-TKI combined chemotherapy survived better than pure chemotherapy,and the latter was superior to the pure EGFR-TKI.Conclusion Congestive pleural effusion has bad curative effect and worse overall survival.Local application of IL-2 chest biological treatment has better effect and overall survivaladvantage.