实用老年医学

实用老年医学 ›› 2025, Vol. 39 ›› Issue (10): 1024-1027.doi: 10.3969/j.issn.1003-9198.2025.10.011

• 临床研究 • 上一篇    下一篇

肌少性肥胖及慢性炎症与老年转移性驱动基因阴性非小细胞肺癌病人预后的相关性研究

刘苏瑶, 孟丽娟   

  1. 210024 江苏省南京市,南京医科大学附属老年医院血液肿瘤科(刘苏瑶);
    210029 江苏省南京市,南京医科大学第一附属医院肿瘤科(孟丽娟)
  • 收稿日期:2025-01-26 发布日期:2025-10-28
  • 通讯作者: 孟丽娟,Email:hellomlj@njmu.edu.cn

Correlation of sarcopenic obesity and chronic inflammation with prognosis in elderly patients with metastatic driver negative non-small cell lung cancer

LIU Suyao, MENG Lijuan   

  1. Department of Hematology Oncology, Geriatric Hospital of Nanjing Medical University, Nanjing 210024, China (LIU Suyao);
    Department of Oncology, the First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China (MENG Lijuan)
  • Received:2025-01-26 Published:2025-10-28
  • Contact: MENG Lijuan, Email: hellomlj@njmu.edu.cn

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摘要： 目的 探讨肌少性肥胖(SO)及慢性炎症对老年转移性驱动基因阴性非小细胞肺癌(NSCLC)预后的影响。方法 回顾性分析 2020年1月至2022年12月期间在南京医科大学第一附属医院肿瘤科及南京医科大学附属老年医院肿瘤科住院的99例一线治疗的老年转移性驱动基因阴性NSCLC病人。根据CT人体成分分析结果将病人分为SO组(49例)和非SO组(50例)。2组一线治疗方案为含铂双药化疗联合免疫治疗。慢性炎症指标采用纤维蛋白原/白蛋白(FAR)。比较2组中位无进展生存时间(mPFS)、中位总生存时间(mOS)、FAR及不良反应的差异。结果 SO组和非SO组mPFS分别为7.0个月(95%CI:6.7~7.3)和10.2个月(95%CI:8.9~11.5);mOS分别为 12.0个月(95%CI:10.1~13.9)和18.2个月(95%CI:14.2~22.2)。SO组的mPFS和mOS均显著短于非SO组(P＜0.05)。SO组FAR显著高于非SO组[0.090(0.079～0.098)比0.060(0.050～0.068),P＜0.001],其中SO组高FAR病人比例达18.4%(9例),非SO组仅为4.0%(2例)。49.0%(24例)的SO组病人因不良反应导致化疗强度低于标准强度50%,显著高于非SO组(20.0%)。结论 SO可引起慢性低度炎症,并与老年转移性驱动基因阴性NSCLC病人治疗耐受性差及预后差相关。

关键词: 肌少性肥胖, 慢性炎症, 老年人, 非小细胞肺癌

Abstract: Objective To explore the impact of sarcopenic obesity(SO) and chronic inflammation on the prognosis of the elderly patients with metastatic driver gene-negative non-small cell lung cancer(NSCLC). Methods A total of 99 elderly patients with metastatic driver gene-negative NSCLC treated at Department of Oncology of the First Affiliated Hospital with Nanjing Medical University and Geriatric Hospital of Nanjing Medical University from January 2020 to December 2022 were enrolled retrospectively. The patients were divided into SO group and non-SO group according to the result of CT body composition analysis. The first-line treatment regimen consisted of platinum-based doublet chemotherapy plus immunotherapy. Chronic inflammation was assessed using the fibrinogen-to-albumin ratio(FAR). Median progression-free survival (mPFS), median overall survival (mOS), FAR, and adverse reactions were compared between the groups. Results In SO group and non-SO group, mPFS was 7.0 months (95%CI:6.7-7.3) and 10.2 months (95%CI:8.9-11.5), and mOS was 12.0 months (95%CI:10.1-13.9) and 18.2 months (95%CI:14.2-22.2) respectively. Both mPFS and mOS in SO group were significantly lower than those in non-SO group(P＜0.05) .FAR was 0.090(0.079-0.098) and 0.060(0.050-0.068) in SO group and non-SO group, respectively (P＜0.001). High FAR was present in 18.4% (9 cases) of SO group and 4.0% (2 cases) in non-SO group. The proportion of chemotherapy intensity reduced to <50% of standard due to adverse reactions in SO group was significantly higher than that in non-SO group(49.0% vs 20.0%, P＜0.05). Conclusions SO may induce chronic low-grade inflammation, which is associated with poor treatment tolerance and prognosis in the elderly patients with metastatic driver gene-negative NSCLC.

Key words: sarcopenic obesity, chronic inflammation, aged, non-small cell lung cancer

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