台灣南部肺癌病人存活時間的預測因子

Predicting Factors of Survival in Patients with Lung Cancer in Southern Taiwan

肺癌多年位居十大癌症死因首位，發現時大多已是疾病晚期且預後不佳。本研究採回溯性世代研究設計，從病歷的次級資料進行分析，以台灣南部某三家醫院2014年至2019年之肺癌病人為研究樣本，以存活分析探討影響第IIIB/IV期肺癌病人存活時間的重要因子。回溯資料共收集IIIB/IV期肺癌之病人計1884人，92.3％為非小細胞肺癌，7.7％為小細胞肺癌。在非小細胞肺癌病人中，超過65歲、男性及癌胚抗原（carcinoembryonic antigen, CEA）、組織多胜肽抗原（tissue polypeptide antigen, TPA）、鱗狀細胞癌抗原（squamous cell carcinoma antigen, SCC）等腫瘤標記高於正常值者，其死亡風險較高，而在小細胞肺癌方面，除年齡外CEA是影響預後最大的因素。研究發現年齡、性別、CEA、TPA、SCC等，是影響肺癌病人存活時間的預測因子。此結果可提供醫護人員臨床照護的實證資料，並作為健康照護團隊執行肺癌病人臨床治療之參考。

Lung cancer is top-ranked in cancer as the leading cause of cancer death in Taiwan. It is usually found at late stage and the prognosis is poor. This was a retrospective cohort study of patients with lung cancer treated at three hospitals in southern Taiwan between 2014 and 2019. Patient data were retrospectively collected from the hospitals' databases, and analyzed the prognostic factors of stage IIIB/IV cancer using survival analysis. A total of 1884 stage IIIB/IV lung cancer patients were included in this study. Most were non-small cell lung cancer (92.3%); small cell lung cancer (7.7%). Mortality risks were higher for non-small cell lung cancer patients with the following characteristics: older than 65 years, men, and high carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA) and squamous cell carcinoma antigen (SCC) levels. In small cell lung cancer patients, CEA is the most important prognostic factor besides age. The results of this study suggest that age, gender, CEA, TPA and SCC are correlated with and have predictive effects on lung cancer survival. These results can serve as a reference to support the clinical implementation of nursing practices, and as an important reference for clinical treatment of lung cancer patients.