Abstract
背景与目的腹膜转移（peritoneal carcinomatosis, PC）在肺癌中较为罕见，但预后极差，目前影响PC发生和预后的因素尚不清楚。本研究旨在探讨非小细胞肺癌（non-small cell lung cancer, NSCLC）PC的临床病理特征和治疗情况对预后的影响。方法回顾性分析2010年8月-2018年8月于北京大学第三医院肿瘤化疗与放射病科接受治疗的NSCLC、符合入组条件的PC患者，采集年龄、性别、胸腔积液、基因状态等资料，应用Kaplan-Meier方法进行生存分析。结果共12例PC患者入组，均为异时性转移，PC发生率为1.44%（12/836）；12例患者均为腺癌，确诊肺癌时50%（6/12）患者合并胸腔积液，确诊PC时100%（12/12）患者合并胸腔积液；12例患者中9例含有表皮生长因子受体（epidermal growth factor receptor, EGFR）、间变性淋巴瘤激酶（anaplastic lymphoma kinase, ALK）、ROS原癌基因1受体酪氨酸激酶（ROS proto-oncogene 1 receptor tyrosine kinase, ROS1）突变；含有基因突变患者一线治疗开始后的中位生存期（median overall survival 1, mOS1）和确诊PC后的中位生存期（medial overall survival 2, mOS2）显著高于无突变组，分别为26.0个月和6.0个月比10.0个月和1.5个月（P < 0.05）；确诊PC后治疗组患者的mOS2为6.0个月，显著高于未治疗组的1.0个月（P < 0.05）；确诊PC后，含有血管生成抑制剂治疗组的mOS2为8.5个月，显著高于其他组（P < 0.05）。结论肺腺癌和胸腔积液患者或许是发生PC的高危人群；含有血管生成抑制剂治疗策略或许能给PC患者带来更多获益，需要前瞻性研究进一步验证。
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