中文摘要：

目的探讨影响肺癌相关性高钙血症患者生存时间的影响因素。方法以解放军总医院肿瘤内科2001年1月-2010年12月收治的经病理证实的34例肺癌相关性高钙血症患者作为研究对象,搜集性别、年龄、肿瘤病理类型、器官（骨、肺、肝、肾、脑）转移,远处转移部位的数目、精神症状、确诊肿瘤至出现高钙血症的时间、病程中血钙最高值及治疗方法等临床资料,采用单因素和多因素分析筛选影响患者生存的危险因素。结果 34例患者病程中血钙最高值为2.77～4.87mmol/L,中位值2.94mmol/L。出现高钙血症后生存时间1～1067d,中位生存时间92d。单因素分析显示,影响高钙血症患者的生存时间的因素包括确诊肿瘤至出现高钙血症的时间、精神症状及肾转移（P〈0.0001,P〈0.0001,P=0.0033）。多因素COX回归分析显示,年龄、确诊肿瘤至出现高钙血症的时间、精神症状及肾转移是影响高钙血症患者的生存时间的危险因素（HR=11.483,P=0.006;HR=4.372,P=0.002;HR=6.064,P=0.026;HR=8.502,P=0.011）。结论肺癌相关性高钙血症患者中位生存时间短,预后差。年龄〉50岁、确诊肿瘤至出现高钙血症的时间〉90d、发生精神症状或发生肾转移会导致患者生存时间缩短。

英文摘要：

Objectives To explore the factors influencing survival time in lung cancer associated hypercalcemia patients.Methods Thirty-four patients with pathologically confirmed lung cancer complicated with hypercalcemia,who were treated at the Department of Oncology in General Hospital of PLA from Jan.2001 to Dec.2010,were enrolled in this study.The clinical data analyzed included sex,age,pathological type of the malignancies,organ metastasis（bone,lung,liver,kidney,brain）,number of distal metastatic site,mental status,interval between final diagnosis of lung cancer and of hypercalcemia,peak value of blood calcium during the disease course,treatment methods and so on.Survival analysis was performed with the Kaplan-Meier method and Cox analysis with statistic software SPSS 18.0 to identify the potential prognostic factors.Results The highest blood calcium level ranged from 2.77 to 4.87mmol/L,and the median value was 2.94mmol/L.The patients＇ survival time after diagnosis of hypercalcemia varied from 1 day to 1067 days,and the median survival time was 92 days.With the log-rank test,age above 50 years old,hypercalcemia occurring over 90 days after diagnosis of cancer,central nervous system symptoms and renal metastasis were predictors for poor survival（P=0.048,P=0.001,P=0.000,P=0.003）.In the COX proportional hazard model analysis,age above 50 years old,hypercalcemia occurring over 90 days after cancer diagnosis,central nervous system symptoms and renal metastasis were significant prognostic factors for poor survival（HR=11.483,P=0.006;HR=4.371,P=0.002;HR=6.064,P=0.026;HR=8.502,P=0.011）.Conclusions Patients with lung cancer associated hypercalcemia have a shorter survival time and poor prognosis.Age above 50 years old,hypercalcemia occurring over 90 days after cancer diagnosis,central nervous system symptoms and renal metastasis are significant factors of poor prognosis.