肺癌作为全球恶性肿瘤中发病率和死亡率较高的一种，手术是其主要治疗手段。然而，肺切除手术常引起肺功能下降，影响患者术后功能恢复及生活质量。准确预测术后肺功能对制定个体化手术方案、降低并发症风险及改善患者预后具有重要意义。目前，研究者已开发出多种结合临床指标、影像学参数及生物标志物的预测模型，用于评估肺癌患者术后肺功能变化。然而，现有模型在准确性、特异性、标准化及临床推广方面仍存在诸多挑战。本文系统综述肺癌术后肺功能的影响因素，并对现有预测模型进行总结与评价，以期为患者术前评估、手术方案选择及术后管理提供参考，进而为改善治疗效果与患者生活质量提供理论依据。

       Lung cancer is a kind of malignant tumor with high morbidity and mortality in the world，and surgery is the main treatment．However，pneumonectomy is often accompanied by the loss of lung function，which seriously affects the recovery of lung function and the  quality of life．Accurate prediction of postoperative pulmonary function is of great significance for formulating individualized surgical plans，reducing the risk of complications and improving the prognosis of patients．At present，researchers have developed a variety of predictive models that combine clinical indicators，imaging parameters，and biomarkers to evaluate postoperative lung function changes in patients with lung cancer．However，there are still many challenges in the accuracy，specificity，standardization and clinical promotion of existing models．This paper systematically reviews the influencing factors of lung function after lung cancer surgery，and summarizes and evaluates the existing prediction models，in order to provide a reference for preoperative evaluation，surgical plan selection and postoperative management of patients，and then provide theoretical basis for improving treatment effect and quality of life of patients．

       目的  分析对肺癌化学治疗（化疗）患者采取个性化营养干预联合分级步行运动方案的应用价值。方法   将郑州大学附属郑州中心医院2023年7月—2024年7月符合标准的198例肺癌化疗患者作为研究对象，通过随机数字表法分为观察组和对照组各99例。对照组仅采用个性化营养干预方案，观察组则联合分级步行运动方案，两组患者均在同一时间内入组并接受持续干预3个月。对两组干预前后癌因性疲乏［Piper疲乏修订量表（PFS-R）］、营养状况、睡眠质量［匹茨堡睡眠质量指数（PSQI）］、生活质量［生活质量评估量表（SF-36）］水平予以比较。结果  相较于对照组，干预后观察组PFS-R、PSQI评分较低，白蛋白、前白蛋白、血红蛋白、铁转蛋白水平和SF-36评分较高（P＜0.05）。结论  对肺癌化疗患者采取个性化营养干预联合分级步行运动方案，有利于促进其癌因性疲乏的减轻和营养状态、睡眠质量及生活质量水平的提高。

       Objective  To analyze the effects of personalized nutritional intervention combined with graded walking exercise treatment on cancer-related fatigue and quality of life in lung cancer patients during chemotherapy．Methods  A total of 198 lung cancer patients undergoing chemotherapy who met the criteria in our hospital from July 2023 to July 2024 were selected as the research subjects．They were divided into an observation group and a control group，with 99 cases in each group，by the random number table method．The control group only received individualized nutritional intervention，while the observation group received graded walking exercise additionally．Both groups of patients were enrolled at the same time and received continuous intervention for three months．Cancer-related fatigue（Piper’s Fatigue Scale-Revised［PFS-R］），nutritional status，sleep quality（Pittsburgh Sleep Quality Index［PSQI］），and quality of life（Quality of Life Scale［SF-36］） before and after the intervention were compared between the two groups．Results  Compared with the control group，the observation group had lower PFS-R and PSQI scores and higher albumin，prealbumin，hemoglobin，transferrin levels and SF-36 scores after the intervention（P＜0.05）．Conclusions  Adopting personalized nutritional intervention combined with graded walking exercise for lung cancer patients during chemotherapy is beneficial to promote the reduction of cancer-caused fatigue and the improvement of their nutritional status，sleep quality and quality of life．

      目的 探讨肺癌根治术后患者康复期的症状体验与心理感受, 为完善症状管理和制定个性化康复干预方案提供依据。方法 采用现象学研究法,对15例肺癌根治术后康复期患者进行半结构式访谈, 运用Colaizzi 7步分析法进行归纳和提炼主题。结果 归纳出5个主题, 12个亚主题：多重躯体症状负担持续存在（术后疼痛综合征、顽固性刺激性咳嗽、劳力性呼吸困难、持续性疲劳感）; 负性心理情绪困扰（病耻感、疾病不确定感与复发恐惧）; 心理调适过程（诊断冲击与认知失调、角色适应与主动应对）; 创伤后成长与健康行为转变（生命意义感提升、健康促进行为强化）; 强烈的康复信息支持需求（自我保健知识需求、结构化康复锻炼指导需求）。结论 医护人员应关注肺癌根治术后患者康复期的症状体验, 动态评估患者的身心状况, 制定精准、有效的个性化干预方案, 帮助患者树立康复信心, 改善术后康复体验和提高生活质量。

       Objective  To explore the symptom experience and psychological feelings of patients during the rehabilitation period after radical resection of lung cancer, aiming to provide a basis for improving symptom management and formulating personalized rehabilitation interventions．Methods The phenomenological research method was used to conduct semi-structured interviews with 15 patients in the rehabilitation period after radical surgery for lung cancer．Colaizzi's 7-step analysis method was used to summarize and extract themes．Results Five themes and 12 sub-themes were summarized：Persistent burden of multiple physical symptoms（postoperative pain syndrome, refractory irritative cough, exertional dyspnea, persistent fatigue）; negative emotional experiences（stigma of illness, illness uncertainty and fear of recurrence）; psychological adjustment processes（diagnostic shock and denial, role acceptance and active coping）; post-traumatic growth and health behavior transformation（enhanced sense of meaning in life, strengthened health-promoting behaviors）; strong demand for rehabilitation information support（self-care knowledge, rehabilitation exercise knowledge）．Conclusions Medical staff should pay attention to the symptom experience of patients during the recovery period after radical lung cancer surgery, dynamically assess their physical and mental conditions, develop precise and effective personalized intervention plans, help patients build confidence in recovery, and thereby improve their postoperative rehabilitation experience and quality of life．

      目的   通过生物信息学手段筛选非小细胞肺癌（NSCLC）中的关键靶点基因，识别预后标志物NDC80，并探讨其在NSCLC中的表达意义，进而分析NDC80作为NSCLC基因治疗靶点的可行性。方法   采用癌症基因组图谱（TCGA）TCGA数据库检索NSCLC相关数据，进行加权基因共表达网络分析（WGCNA）以识别关键基因，并进行差异表达分析、相关性分析和蛋白互作网络构建。对筛选出的关键基因进行功能分析。利用免疫组化染色法检测癌组织及癌旁组织中NDC80蛋白的表达水平，并进一步探究其与临床病理特征的关系。采用Kaplan-Meier法分析NDC80表达与NSCLC患者无进展生存时间（PFS）的关系。结果   共筛选出20个与NSCLC高度关联的关键基因，包括CDC20、CDK1、MCM4、CDC6、MCM2、PLK1、NDC80、CCNB1、CDC45、AURKA、MCM8、BUB1、CDT1、ORC1、CCNA2、CASC5、MAD2L1、BUB1B、CENPA、AURKB。免疫组化验证显示，NDC80蛋白在NSCLC组织中高表达，其在NSCLC组（阳性表达率88.6%）显著高于癌旁组（50.0%）（P＜0.05）。NDC80蛋白的阳性表达率在TNM分期（Ⅲ期+Ⅳ期）、低分化、淋巴结转移的NSCLC组高于TNM分期（Ⅰ期+Ⅱ期）、高分化及中分化以及未发生淋巴结转移的NSCLC组（P＜0.05）。NDC80蛋白的阳性表达率在不同性别、年龄、病灶大小分类的NSCLC组织中无显著差异（P＞0.05）。Kaplan-Meier分析显示，NDC80蛋白高表达组的PFS中位数为（9.00±0.27）个月，明显低于低表达组（11.00±0.79）个月（P＜0.05）。结论   本研究发现的关键基因在NSCLC干细胞的维持中发挥重要作用。免疫组化结果显示，NDC80蛋白在NSCLC组织中高表达，且与肿瘤分化、TNM分期及淋巴结转移密切相关。NDC80蛋白高表达组的PFS明显低于低表达组，提示NDC80可能成为NSCLC筛查、治疗和预后评估的潜在生物标志物。

      Objective  To screen the key target genes in non-small cell lung cancer（NSCLC）by bioinformatics，identify the prognostic marker NDC80，and explore its expression significance in NSCLC，so as to analyze the feasibility of NDC80 as a gene therapy target for NSCLC．Methods  TCGA database was used to retrieve NSCLC-related data，and weighted gene co-expression network analysis（WGCNA）was used to identify key genes，and differential expression analysis，correlation analysis and protein-protein interaction network construction were carried out．The function of the selected key genes was analyzed．Immunohistochemical staining was used to detect the expression level of NDC80 protein in cancer tissues and adjacent tissues，and to further explore its relationship with clinicopathological features．Kaplan-Meier method was used to analyze the relationship between NDC80 expression and progression-free survival （PFS）of NSCLC patients．Results  A total of 20 key genes highly associated with NSCLC were screened out，which were CDC20，CDK1，MCM4，CDC6，MCM2，PLK1，NDC80，CCNB1，CDC45，AURKA，MCM8，BUB1，CDT1，ORC1，CCNA2，CASC5，MAD2L1，BUB1B and CENPA．Immunohistochemical  verification  showed that NDC80 protein was highly expressed in NSCLC tissue，and its positive expression rate in NSCLC group（88.6%）was significantly higher than that in adjacent cancer group（50.0%，P＜0.05）．The positive expression rate of NDC80 protein in NSCLC with TNM staging（Ⅲ+Ⅳ），low differentiation and lymph node metastasis was higher than that in NSCLC with TNM staging（Ⅰ+Ⅱ），high differentiation and moderate differentiation and no lymph node metastasis（P＜0.05）．There was no significant difference in the positive expression rate of NDC80 protein among NSCLC tissues with different gender，age and lesion size（P＞0.05）．Kaplan-Meier analysis showed that the median PFS of high expression group of NDC80 protein was（9.00±0.27）months，which was significantly lower than that of low expression group（11.00±0.79）months（P＜0.05）．Conclusions  The key genes found in this study play an important role in the maintenance of NSCLC stem cells．Immunohistochemical results showed that NDC80 protein was highly expressed in NSCLC，and it was closely related to tumor differentiation，TNM staging and lymph node metastasis．The PFS of high expression group of NDC80 protein was significantly lower than that of low expression group，suggesting that NDC80 may become a potential biomarker for screening，treatment and prognosis evaluation of NSCLC．

      目的   探讨肺癌伴癌性疼痛患者心理僵化现状及其影响因素，为临床制定改善患者心理僵化的针对性干预措施以及提升患者生活质量提供参考依据。方法   采用便利抽样法，选取2023年10月—12月期间焦作市某三级甲等医院收治的肺癌伴癌性疼痛患者为研究对象，采用一般资料调查问卷、疼痛心理僵化量表（PIPS）、简易疾病感知问卷（BIPQ）、家庭功能问卷（APGAR）进行调查，采用Pearson相关性分析肺癌伴癌性疼痛患者心理僵化与疾病感知、家庭功能的关系。采用多元线性回归分析肺癌伴癌性疼痛患者心理僵化的影响因素。结果   本次研究共发放问卷152份，回收有效问卷150份，有效回收率为98.68%。150例肺癌伴癌性疼痛患者心理僵化量表总分为（61.66±2.85）分，回避型经验维度得分为（45.52±1.97）分，认知融合维度得分为（19.74±1.59）分。不同文化程度、家庭人均月收入、疼痛程度的肺癌伴癌性疼痛患者心理僵化得分比较，差异有统计学意义（P＜0.05）。Pearson相关性分析结果显示：肺癌伴癌性疼痛患者心理僵化总分、经验性回避维度得分、认知融合维度得分与疾病感知得分均呈正相关关系（P＜0.001），与家庭功能得分均呈负相关关系（P＜0.001）。多元线性回归结果显示：文化程度、家庭人均月收入、疾病感知、家庭功能是肺癌伴癌性疼痛患者心理僵化的影响因素（P＜0.05），可解释肺癌伴癌性疼痛患者心理僵化43.9%的变异度。结论   肺癌伴癌性疼痛患者心理僵化处于较高水平，且受到文化程度、家庭人均月收入、疾病感知和家庭功能的影响，临床医护人员可从疾病感知、家庭支持等角度出发，采用认知干预、同伴支持等方法，加强对患者的健康教育，以缓解其对疾病的负性认知，从而缓解心理僵化，促进身心健康恢复。

       Objective  To explore the status and influencing factors of psychological  rigidity in patients with lung cancer and cancer pain，and to provide reference for clinical development of targeted interventions to improve patients’psychological rigidity andquality of life．Methods  The convenience sampling method was used to select patients with lung cancer and cancer pain who were admitted to a tertiary hospital in Jiaozuo City from October to December 2023 as the research object．The general data questionnaire，Psychological Inflexibility in Pain Scale（PIPS），Brief Illness Perception Questionnaire（BIPQ），and family function questionnaire（APGAR）were used to investigate．Pearson correlation analysis was used to analyze the relationship between psychological rigidity and disease perception and family function in patients with lung cancer and cancer pain．Multivariate linear regression was used to analyze the influencing factors of psychological rigidity in patients with lung cancer and cancer pain．Results  A total of 152 questionnaires were distributed in this study，and 150 valid questionnaires were recovered，with an effective recovery rate of 98.68 %．The total score of PIPS of 150 patients with lung cancer and cancer pain was（61.66±2.85），the score of avoidance experience dimension was（45.52±1.97），and the score of cognitive fusion dimension was（19.74±1.59）．There were statistically significant differences in the scores of psychological rigidity among lung cancer patients with cancer pain with different educational levels，family per capita monthly income，and pain degree（P＜0.05）．The  results of Pearson correlation analysis showed that the total score of PIPS，the score of empirical avoidance dimension and the score of cognitive fusion dimension were positively correlated with the score of disease perception（P＜0.001），and negatively correlated with the score of family function（P＜0.001）．The results of multiple linear regression showed that education level，family per capita monthly income，disease perception and family function were the influencing factors of psychological rigidity in patients with lung cancer and cancer pain（P＜0.05 ），which could explain 43.9 % of the variation of psychological rigidity in patients with lung cancer and cancer pain．Conclusions  The psychological rigidity of lung cancer patients with cancer pain is at a high level，and is affected by education level，family per capita monthly income，disease perception and family function．Clinical medical staff can use cognitive intervention and peer support from the perspective of disease perception and family support to strengthen the health education of patients，so as to alleviate their negative cognition of the disease，to alleviate the psychological rigidity and promote the recovery of physical and mental health．

目的 探讨导航护士主导的三级质控在胸腔镜肺癌切除术患者加速康复中的应用效果。方法 选取2020年6月—2023年6月周口市中心医院收治的106例肺癌患者,应用随机数字表法分为观察组（n=53）与对照组（n=53）。患者均采取胸腔镜肺癌切除术治疗,对照组实施常规的术前、术中及术后相关围术期护理,观察组在常规围术期护理基础上增加导航护士主导的三级质控护理。对比两组住院时间、术后并发症和护理前后世界卫生组织生活质量-100量表（WHOQOL-100）及癌因性疲乏程度（PFS）,最后对比两组的护理满意度。结果 观察组首次排气时间、首次下床时间、术后疼痛视觉模拟量表（VAS）评分、术后住院时间均优于对照组（P<0.05）;观察组并发症发生率低于对照组（P<0.05）;干预后两组WHOQOL-100评分升高、PFS评分降低,观察组均优于对照组（P<0.05）;观察组护理满意度高于对照组（P<0.05）。结论 对胸腔镜肺癌切除术患者,采取导航护士主导的三级质控管理的加速康复护理,可促进患者术后肠胃功能恢复,缩短住院时间,减轻术后疼痛感与减少并发症,在改善患者癌因性症状的同时,提升其生活质量,提高患者护理满意度。

Objective To explore the application effect of three-level quality control led by navigation nurses in accelerating rehabilitation of patients undergoing thoracoscopic lung cancer resection．Methods A total of 106 lung cancer patients admitted to our hospital from June 2020 to June 2023 were selected and randomly divided into an observation group（n=53）and a control group（n=53）using a random number table method．All patients were treated with thoracoscopic lung cancer resection,while the control group received routine preoperative,intraoperative and postoperative perioperative care,the observation group received a three-level quality control nursing led by navigation nurses in addition to routine perioperative care．The length of hospitalization,postoperative complications,WHOQOL-100 and PFS before and after care,and the nursing satisfaction of the two groups were compared．Results The observation group had significantly shorter first exhaust time,first time out of bed,postoperative visual analogue scale（VAS）score and postoperative hospital stay compared to the control group（P<0.05）．The incidence of complications in the observation group was lower than that in the control group（P<0.05）．After intervention,the WHOQOL-100 scores of both groups increased,and the observation group was higher than the control group．The PFS score decreased,and the observation group was lower than the control group（P<0.05）．The nursing satisfaction of the observation group was significantly higher than that of the control group（P<0.05）．Conclusions Adopting a three-level quality control management led by navigation nurses to accelerate rehabilitation care for patients undergoing thoracoscopic lung cancer resection can promote postoperative recovery of gastrointestinal function,reduce hospitalization time,reduce postoperative pain and complications,improve cancer related symptoms,improve their quality of life and increase patients nursing satisfaction．

本文探讨临床药师对口服靶向药物的非小细胞肺癌患者开展药学服务的要点,以案例为依据,通过查阅药品说明书、指南及文献等,分析药学服务的内容和方向。临床药师在安全性评估、剂量调整、个体化治疗方案选择、用药教育和健康宣教等方面为患者和临床医生提供专业、全面的药学服务。临床药师通过全程参与患者的治疗过程,指导患者正确用药、优化治疗方案,利用专业优势解决临床实际问题,提升药学服务质量的同时体现了药师的职业价值。

To explore the key points of pharmaceutical care for non-small cell lung cancer patients with oral targeted drugs．Based on clinical cases,the content and direction of pharmaceutical care were analyzed with drug instructions,guidelines and literature．Clinical pharmacists provided professional and comprehensive pharmaceutical services for patients and clinicians in safety assessment,dose adjustment,individualized treatment plan selection,medication education and health education．Clinical pharmacists participate in the whole treatment process,guide patients to use drugs correctly,optimize treatment plans,use professional advantages to solve clinical practical problems,improve the quality of pharmaceutical care and reflect the professional value of pharmacists．

目的 探讨表皮生长因子受体酪氨酸酶抑制剂（EGFR-TKIs）一线治疗耐药后,二线化学治疗（化疗）联合程序性死亡蛋白1及其配体（PD-1/L1）免疫检查点抑制剂方案对晚期非小细胞肺癌（NSCLC）的疗效。方法 选取2018年 6月—2022年10月期间就诊于南通大学附属肿瘤医院院的80例有完整临床资料、应用EGFR-TKIs耐药后晚期NSCLC患者进行回顾性分析,依照不同治疗方式将患者分为观察组与对照组,均为40例。对照组一线EGFR-TKIs治疗耐药后进行二线化疗,观察组一线EGFR-TKIs治疗耐药后进行二线化疗联合PD-1/L1免疫检查点抑制剂治疗。对比两组临床疗效及无进展生存期（PFS）,化疗前后血清中人细胞角蛋白21-1片段（Cyfra21-1）、糖类抗原125（CA125）、碱性成纤维细胞生长因子（bFGF）、血管内皮生长因子（VEGF）水平变化,不良反应发生率及生存质量。结果 观察组客观缓解率与疾病控制率高于对照组（P<0.05）,对照组PFS为10（2.38,24.13）个月,观察组PFS为14（5.27~,5.27）个月,观察组高于对照组（χ²=4.536,P=0.041）;化疗后两组bFGF、VEGF,CA125、Cyfra21-1肿瘤标志物水平均比化疗前降低,且观察组[（17.85±3.32）ng/L、（310.51±88.37）ng/L、（51.62±13.66）U/mL、（10.26±3.37）ng/mL]低于对照组[（19.62±3.24）ng/L、（366.26±49.42）ng/L、（59.26±9.35）U/mL、（12.62±2.73）ng/mL],对比差异有统计学意义（t₁=2.413,P₁=0.018;t₂=3.482,P₂<0.001;t₃=2.919,P₃=0.005;t₄=3.442,P₄<0.001）;两组不良反应发生率对比差异无统计学意义（P>0.05）;化疗后两组世界卫生组织生存质量量表简表评分均升高,观察组[（98.62±8.24）、（101.53±12.62）、（95.28±11.15）、（97.79±10.47）分]高于对照组[（84.25±7.32）、（93.58±15.75）、（82.24±9.34）、（83.47±8.38）]分,对比差异有统计学意义（t₁=8.246,P₁<0.001;t₂=2.491,P₂=0.015;t₃=5.670,P₃<0.001;t₄=6.753,P₄<0.001）。结论 对EGFR-TKIs耐药后晚期非小细胞肺癌患者采取二线化疗联合PD-1/L1免疫检查点抑制剂可提升其临床疗效及生存期,改善血清相关肿瘤标志物表达水平,提升患者生存质量。

Objective To explore the therapeutic effect of second-line chemotherapy combined with PD-1/L1 immune checkpoint inhibitor regimen on advanced non-small cell lung cancer（NSCLC） after epidermal growth factor receptor-tyrosine kinase inhibitors（EGFR-TKIs）resistance in first-line chemotherapy．Methods Retrospectively selected 80 patients with advanced NSCLC EGFR TKIs resistance,who were admitted to the Affiliated Cancer Hospital of Nantong University from June 2018 to October 2022．Patients were divided into an observation group and a control group according to different treatment methods,with 40 cases in each group．The control group received second-line chemotherapy after first-line EGFR-TKIs therapy resistance,while the observation group received second-line chemotherapy and PD-1/L1 inhibitor after first-line EGFR-TKIs therapy reactions and quality of live．Clinical efficacy and PFS,changes in serum levels of human Cyfra21-1,CA125,bFGF,VEGF,incidence of adverse chemotherapy of two groups were compared．Results The ORR and DCR of the observation group were significantly higher than those of the control group（P<0.05）．The mean PFS of the control group was 10（2.38-24.13）months,while the mean PFS of the observation group was 14（5.27-35.27）months．The observation group was higher than the control group（χ²=4.536,P=0.041）．After chemotherapy,levels of bFGF,VEGF,CA125 and Cyfra21-1 tumor markers decreased in both groups,and the observation group [（17.85±3.32）ng/L,（310.51±88.37）ng/L,（51.62±13.66）U/mL,（10.26±3.37）ng/mL] was lower than the control group [（19.62±3.24）ng/L,（366.26±49.42）ng/L,（59.26±9.35）U/mL,（12.62±2.73）ng/mL],which showed statistically significant difference in the comparison（t₁=2.413,P₁=0.018;t₂=3.482,P₂<0.001;t₃=2.919,P₃=0.005;t₄=3.442,P₄<0.001）．There was no significant difference in the incidence of adverse reactions between the two groups（P>0.05）．After treatment,the WHO QOL-BREF scores increased in both patient groups and the observation group scores[（98.62±8.24）,（101.53±12.62）,（95.28±11.15）,（97.79±10.47）] were higher than the control group scores[（84.25±7.32）,（93.58±15.75）,（82.24±9.34）,（83.47±8.38）],which showed statistically significant difference．（t₁=8.246,P₁<0.001;t₂=2.491,P₂=0.015;t₃=5.670,P₃<0.001;t₄=6.753,P₄<0.001）．Conclusions The combination of second-line chemotherapy with PD-1/L1 immune checkpoint inhibitors can improve the clinical efficacy and survival of advanced NSCLC patients who are resistant to EGFR-TKIs,improve the expression levels of serum related tumor markers,and enhance the quality of life of patients．

目的 分析非小细胞肺癌化疗患者骨髓抑制发生状况及其影响因素。方法 回顾性分析2017年2月—2019年8月期间本院进行化疗治疗的80例非小细胞肺癌患者临床资料,统计非小细胞肺癌化疗患者骨髓抑制发生情况,并根据其情况分组;收集所有患者临床资料,分析非小细胞肺癌化疗患者骨髓抑制发生的相关影响因素。结果 80例非小细胞肺癌化疗患者中发生骨髓抑制45例,发生率为56.25%;经单因素及多项Logistic回归分析,年龄≥60岁、化疗方案为紫杉醇联合铂类,TNM分期在Ⅲ-Ⅳ期,发生骨转移是非小细胞肺癌化疗患者发生骨髓抑制的影响因素(OR＞1,P＜0.05)。结论 年龄≥60岁、化疗方案为紫杉醇联合铂类,TNM分期在Ⅲ-Ⅳ期,发生骨转移会增加非小细胞肺癌化疗患者骨髓抑制的发生风险,临床上可据此来制定合理的干预措施,以降低患者骨髓抑制的发生风险。

Objective To analyze the occurrence and influencing factors of bone marrow suppression in patients with non-small cell lung cancer (NSCLC) undergoing chemotherapy. Methods The clinical data of 80 patients with NSCLC who received chemotherapy in our hospital from February 2017 to August 2019 were retrospectively analyzed, the occurrence of bone marrow suppression in patients with NSCLC under chemotherapy was enrolled and grouped according to the situation; the clinical data of all patients were collected, the related influencing factors of bone marrow suppression in patients were analyzed. Results Among 80 cases of patients with NSCLC, 45 cases occurred bone marrow suppression, the incidence was 56.25%; after univariate and multivariate Logistic regression analysis, age ≥ 60 years old, chemotherapy of paclitaxel combined with platinum, TNM stage in stage III -IV, the occurrence of bone metastasis were the influencing factors of bone marrow suppression in patients with NSCLC under chemotherapy (OR>1, P<0.05). Conclusions Age ≥ 60 years old, chemotherapy of paclitaxel combined with platinum, TNM stage in stage III -IV, the occurrence of bone metastasis will increase the risk of bone marrow suppression in patients with NSCLC chemotherapy. Therefore, reasonable intervention measures can be carried out to reduce the risk.

目的 探讨气道径向超声(RP-EBUS)引导多维度联合检查对周围型肺癌的诊断价值。方法 选取2019年9月—2021年12月于佛山市第二人民医院确诊的74例周围型肺癌患者,分析RP-EBUS引导肺活检、支气管黏膜刷检、支气管肺泡灌洗细胞学及DNA甲基化检测等多维度联合检查对周围型肺癌的诊断阳性率及影响因素。结果 RP-EBUS引导肺活检、支气管黏膜刷检、支气管肺泡灌洗液细胞学、DNA甲基化检测对周围型肺癌的诊断阳性率分别为52.7%、47.3%、45.9%和51.4%,RP-EBUS引导多维度联合检查阳性率为71.6%,高于单一方法检查(P<0.05);RP-EBUS引导多维度联合检查病灶直径≥30 mm诊断阳性率高于病灶直径＜30 mm (82.9% vs 57.6%),差异有统计学意义(P<0.05);RP-EBUS引导多维度联合检查在肺上叶、中叶/舌叶、下叶病灶的阳性率分别为69.7%、66.7%和76.9%,差异无统计学意义(P>0.05);联合检查中超声探及病灶的诊断阳性率高于超声未探及病灶(76.9% vs 33.3%),差异有统计学意义(P<0.05);病灶超声图像表现为中心均实型的联合检查诊断阳性率高于非中心均实型(86.0% vs 59.1%),差异有统计学意义(P<0.05)。结论 RP-EBUS引导多维度联合检查对周围型肺癌有更高的诊断阳性率,诊断阳性率与病灶大小、超声是否探及病灶及病灶超声图像特征有关,与病灶部位无关。

Objective To investigate the value of radial probe endobronchial ultrasound (RP-EBUS)guided multi-dimensional combined examination in the diagnosis of peripheral lung cancer. Methods A retrospective analysis of 74 patients with peripheral lung cancer which were diagnosed in Foshan Second People's Hospital from September 2019 to December 2021 was carried out. RP-EBUS guided biopsy, brushing biopsy, bronchus alveolar lavage cytology and DNA methylation detection results were analyzed to obtain the positive diagnosis rate and influencing factors. Results The positive rates of RP-EBUS guided biopsy, brushing biopsy, bronchus alveolar lavage cytology and methylation for peripheral lung cancer were 52.7%, 47.3%, 45.9% and 51.4%, respectively. The positive rate of RP-EBUS guided multi-dimensional combined detection was 71.6%, which was significantly higher than single detection (P<0.05). The positive rate of RP-EBUS multi-dimensional combined examination in lesions diameter ≥30 mm was higher than that of lesion diameter ＜30 mm (82.9% vs 57.6%, P<0.05). The positive rate of RP-EBUS guided multi-dimensional combined group in the upper lobe, middle lobe/lingual lobe, and lower lobe of the lung were 69.7%, 66.7% and 76.9%, respectively, with no significant difference (P>0.05). The positive rate of ultrasound detected lesion in combined group was higher than that of undetected lesions (76.9% vs 33.3%, P<0.05). The ultrasound images of solid center lesions had higher positive rates than that of non solid center lesions (86.0% vs 59.1%, P<0.05). Conclusions RP-EBUS guided multi-dimensional combined examination has a higher positive rate for diagnosis of peripheral lung cancer. The positive rate of diagnosis are related to the size of the lesion, whether the lesion is detected by ultrasound and the characteristics of the ultrasound image of the lesion, but not related to the location of the lesion.