Risk Factors And Survival Analysis Of Brain Metastasis In Lung Adenocarcinoma

Objective Lung cancer is one of the most common malignant tumors in China,Although the current treatment can reduce the incidence of lung cancer brain metastasis and improve its survival rate.However,we can not ignore the prognostic factors and the risk factors of brain metastasis.In this study,we retrospectively analyzed the prognostic factors of brain metastasis in lung adenocarcinoma,and predicted the risk factors for brain metastases in patients with lung adenocarcinoma.Method This study is a retrospective study.Univariate analysis was performed with Kaplan-Meier method,and plot survival curves.survival rate was compared with log-rank test,and multivariate analysis was performed with Cox regression model.The single factor analysis of brain metastasis was ?2 test,and the multivariate analysis was logistic regression.The correlation between lymphocyte subsets and distant metastasis in TCGA data was analyzed by R language,GSEA and SVM models.Result 1.The median survival time of brain metastasis group was 15.2 months,and that of non-brain metastasis group was 30.0 months(P=0.011).The difference was statistically significant.2.Single factor survival analysis showed that the pretreatment of hemoglobin,neutrophils,percentage of lymphocytes,and albumin were related to the prognostic of brain metastases of lung adenocarcinoma(P<0.05).Multivariate Cox regression analysis showed that hemoglobin and neutrophils were independent prognostic factors.3.Univariate analysis of brain Metastasis showed that age?60 years old,T4,N2-3,other distant metastases and the pretreatment of LYM<1.1*10^9/L,LYM%<20,LDH>250U/L,CEA>6.5ng/ml,NSE>16.3ng/ml were risk factors for brain metastases of lung adenocarcinoma(P<0.05).Multivariate logistic regression analysis showed that age,N stage,other distant metastases,CEA,NSE were independent risk factors.4.The TCGA database further confirmed that low lymphocyte percentage increased the risk of distant metastases of early lung adenocarcinoma.Conclusions 1.The occurrence of brain metastases is associated with survival in patients with lung adenocarcinoma.2.The pretreatment of hemoglobin,neutrophils,percentage of lymphocytes,and albumin are related to the prognostic of brain metastases of lung adenocarcinoma.3.Age?60 years old,T4,N2-3,other distant metastases and the pretreatment of LYM<1.1*10^9/L,LYM%<20,LDH>250U/L,CEA>6.5ng/ml and NSE>16.3ng/ml were risk factors for brain metastases of lung adenocarcinoma.4.Low lymph node cell infiltration ratio,especially in early lung low adenocarcinoma patients with reduced CD8 lymphocytes susceptible to distant metastases.