肺癌副癌综合征104例

Paraneoplastic syndromes related to lung cancer: an analysis of 104 cases

目的 为防止肺癌诊断的延误 ,对肺癌副癌综合征进行讨论。方法 我院 80～ 90年代有病理及细胞学确诊的 10 48例肺癌病人 ,分析其有副癌综合征的病例与肺癌的关系。结果 有副癌综合征者 10 4例 (9 9% ) ,其中杵状指常见 ,为 34 6 % ,神经系副癌综合征为 2 4 0 % ,异位内分泌综合征为 2 1 1% ,肥大性骨关节病为 13 8% ,血栓性静脉炎为 7 7% ,肺动脉血栓栓塞为 5 8% ,非细菌性血栓性心内膜炎及皮肌炎为 3 9%等。结论 因临床医师对上述综合征与肺癌的关系不熟悉或未予重视 ,95 2 %有副癌综合征的病例被延误了肺癌的诊断 。

Objective To discuss the paraneoplastic syndromes of lung cancer in order to prevent missing of the diagnosis of lung cancer. Method The clinical data of lung cancer patients confirmed by pathology or cytology in PUMC hospital in the last 20 years were analyzed in order to study the relationship between lung cancer and paraneoplastic syndromes. Results 104(9.9%) of the 1 048 patients were found to have paraneoplastic syndromes. Digital clubbing was very common; it occurred in 34.6% of the 104 cases. The other findings were as follows: neurologic paraneoplastic syndromes 24 0%, ectopic endocrinologic syndromes 21.1%, hypertrophic pulmonary osteoarthropathy 13.5%, thrombophlebitis 7.7%, pulmonary embolism 5.8% and nonbacterial thrombotic endocarditis(3.9%) and dermatomyositis 3.9 %. Conclusions Because some physicians are not familiar with the relationship between paraneoplastic syndromes and lung cancer, 95.2% of the lung cancers with paraneoplastic syndromes are missed. For patients with the above presentations, physicians should investigate more carefully to find if they have concealed lung cancers.