1279例肺癌患者临床特征及生存率分析

Analysis of clinical characteristics and survival rates in 1279 lung cancer patients

背景与目的:全球肺癌的发病率和死亡率正逐年增加,基于此背景,本研究观察上海市专科医院肺癌住院患者的临床特征及生存情况。方法:以2000年1月——2001年12月期间于上海市胸科医院诊治的所有沪籍肺癌住院患者作为研究对象,通过病历回顾收集相关资料。采用描述性分析和寿命表法进行生存分析。结果:1 279例患者的平均年龄为61岁,女性(59.0岁)低于男性(61.9岁),吸烟者占62.9%,116例有肿瘤家族史。在各种病理类型肺癌中,腺癌比例最高,占44.3%,其次分别是鳞癌、小细胞肺癌,男性肺癌以鳞型多见,女性以腺型为主。88.2%的患者是出现不适症状后才就诊的。从分期上看,65.3%的病例首次诊断时都已是Ⅲ、Ⅳ期;单纯手术治疗380例,手术联合放化疗91例,手术加化疗164例,手术加放疗17例,单纯化疗304例,放化疗140例及未治疗患者166例。生存分析结果显示,中位生存期1.46年,1、3、5和8年的生存率分别是59.4%、31.4%、24.4%和18.8%,鳞癌生存期高于腺癌,女性患者生存期高于男性。结论:不同性别肺癌患者的病理类型、临床分期、治疗方式与生存期存在差异。要积极提高肺癌高危人群定期体检的可行性,提高组织病理学的确诊率,并采取针对性的治疗方法,以改善肺癌患者的预后。

Background and purpose:The worldwide incidence and mortality of lung cancer is continually increasing.This study aimed to observe the survival and clinical features of lung cancer patients treated in Shanghai Chest Hospital.Methods:We studied the characteristics of all the local patients with lung cancer treated in Shanghai Chest Hospital during Jan.2000 to Dec.2001 by cases reviewing and data extracting.And we used descriptive analysis and life table method on survival analysis.Results:The average age of the 1 279 patients was 61,and female's(59.1) was lower than male's(61.9).Among the patients,62.9% were smoker and 116 cases had family history of tumor.Adenocarcinoma was the highest proportion in the variety of pathological types with the accounting for 44.3%,followed by squamous and small cell lung cancer.More male patients were suffered from squamous lung cancer,while patients with adenocarcinoma were more common in female.88.2% of patients seeked treatment after the appearance of the symptoms.The stage of tumor: 65.3% patients were firstly diagnosed stage Ⅲ and stage Ⅳ.The treatments: 380 cases received surgery only,91 cases received surgery and chemoradiotherapy,164 cases received surgery and chemotherapy,17 cases received surgery and radiotherapy,304 patients received chemotherapy,140 cases received chemoradiotherapy,and 166 cases did not received any treatment.Survival analysis results showed that the median overall survival was 1.46 years,1,3,5 and 8 years of survival rates were 59.4%,31.4%,24.4% and 18.8%.Survival rates of patients with squamous carcinoma were better than those with adenocarcinoma,the survival rates female patients were better than male patients.Conclusion:The types of pathology,clinical stages,treatments and survival were different between the different gender.The feasibility of periodic medical examinations for high-risk groups and the diagnosis rate of histopathology should be improved.We should use the right treatment methods and to improve the prognosis of patients with lung cancer.