以鳞癌为主的青年人肺癌纤支镜检查分析

Fibrobronchoscopic observation of squamous cell carcinoma as the leading subtype in young patients with lung cancer

目的 探讨青年肺癌在纤支镜下的特征及病理特点。方法 对 14 2例 4 0a以下青年肺癌纤支镜检查资料进行回顾性分析。结果 青年肺癌占同期肺癌的 8.9% ,男女比例为 2 .6 / 1,组织学分型明确的 91例青年肺癌中鳞癌居首位 ( 5 8.2 % ) ,其次为小细胞癌 ( 2 3.1% )和腺癌 ( 18.7% ) ;14 2例青年肺癌镜下改变以直接征象为主 ( 83.1% ) ,间接征象占 14 .8% ,有 3.5 %镜下未见异常 ,发生部位右肺多于左肺 ,双上肺最常见 ;刷检细胞学诊断阳性率 77.5 % ,病理学诊断阳性率 6 4 .1%。结论 青年肺癌临床表现无特殊性而易误诊 ,应提高对青年肺癌的警惕性 。

Objective To study the clinicopathologic characteristics and the features of fibrobronchoscopy in lung cancer patients under 40 years of age. Methods We analysed retrospectively the fibrobronchoscopic data of 142 young lung cancer patients enrolled between July 1981 and October 2002. Results The proportion of young patients with lung cancer in all lung cancer patients was 8.9%,the male /female ratio was 2.6/1. The most frequent histologic types was squamous cell carcinoma (58.2%), followed by small cell carcinoma (23.1%) and adenocarcinoma (18.7%) in 91 young patients with histologically proven lung cancer . Among 142 young lung cancer patients, 83.1% had direct sign, 14.8% had indirect sign, 77.5% showed the positive results by cytology, 64.1% showed the positive pathologic results by bronchos copy, 59.5% were right lung cancer,the most common region was in the double upper lobes. Conclusions Lung cancer in young patients are prone to be misdiagnosed pneumonia or tuberculosis.Therefore,it is necessary to pay more attention to the lung cancer of young patients.