经纤维支气管镜诊断40岁以下青年肺癌特点

Characteristics of lung cancer diagnosed by fibrobronchoscopy in patients under 40

目的探讨纤维支气管镜诊断青年肺癌的临床特点以及组织学类型与年龄段、性别、部位和镜下表现间的关系。方法对104例40岁以下青年肺癌纤维支气管镜检查资料进行回顾性分析。结果男女比例为1.6/1.0,女性比例较中老年患者高(P<0.005)。组织学分型明确的88例中鳞癌居首位39.8%,其次为小细胞癌26.1%和腺癌22.7%;104例青年肺癌镜下改变以直接征象为主(75.0%),间接征象占25.0%,鳞癌多呈菜花样新生物,小细胞癌主要呈息肉样新生物和浸润性改变,腺癌则以息肉样新生物和外压及充血水肿兼有为主。病变部位在左右肺的发生率无明显区别(P>0.05),但鳞癌多发于右肺(P<0.005)。结论纤维支气管镜检查是诊断青年肺癌的重要手段,提高对青年肺癌认识和警惕,借助纤维支气管镜检查有助于早期诊断。

[ Objective ] To study the clinic characteristics and the relation of histopathology with age, gender, location and the sign of fibrobronchoscopy in lung cancer patients diagnosed by fibrobronchoscopy under 40 years of age. [Methods] We analyzed retrospectively the fibrobronchoscopy data of 104 young lung cancer patients enrolled between January 1980 and December 2004. [Results] Of the 104 patients, the male/female ratio was 1.6/1. Compared with the more common older patients, the young patients had an increased percentage of women （P 〈0.005）. The most common histopathology was squamous cell carcinoma （39.8%）, followed by small cell carcinoma （26.1%） and adenocarcinoma （22.7%） in 88 young patients with histologically proven lung cancer. Among 104 young lung cancer patients, 75.0% had direct sign, and 25.0% had indirect sign. Most squamous cell carcinoma had cauliflower-hke tumour, most small cell carcinoma had polypus-hke tumour or infiltrative lesion, while most adenocarcinoma had polypus-like tumour or indirect sign. There were not obviously different about the cancer＇s distribution between left and right lungs （P 〉0.05） while the location of squamous cell carcinoma was more in the right lung （P 〈0.005）, [Conclusion] This study suggests fibrobrochoscopy is an important approach in diagnosis of young lung cancer. Paying more attention to the lung cancer of young patients and examining with fibrobronchoscopy would be helpful to earlier diagnosis.