40岁以下青年人肺癌的临床及病理学特征

Clinico-pathologic and Prognostic Studies on Lung Adenocarcinoma Patients Under 40 Years of Age

【目的】探讨青年人肺癌(年龄≤40岁)的临床及病理学特征及预后等方面与中老年人肺癌(年龄≥40岁)的差异。【方法】对1998年10月至2003年10月期间收治的43例青年人肺癌(青年组)及同期收治的186例中老年人肺癌(中老年组)进行回顾性分析,比较两组临床及病理学特征和预后。【结果】与中老年组相比,青年组中女性多(46.5%比29.0%,P<0.05),腺癌比例明显增高(67.5%比25.8%)、Ⅲb～Ⅳ期病变多(73.6%比59.2%)而鳞状细胞癌比例明显低于中老年组(16.3%比56.5%)。青年组中手术治疗及化疗的比例均高于中老年组。中老年组中更倾向于保守治疗。但两组之间的总体生存率无明显差异。【结论】青年人肺癌与中老年人肺癌相比,女性患者比例明显增高,腺癌比例增高,疾病进展迅速,恶性程度高。早期诊断、积极治疗能提高肺癌的生存率。

[Objective]To study whether the clinicopathologic features and prognosis of lung cancer in younger patients differ from those of lung cancer patients≥40 years of age. [Methods]Among lung cancer patients treated during the period from October 1998 to October 2003, the clinicopathologic features and prognosis of 43 patients under 40 years of age （younger group） were compared with those of 186 patients with 60 years of age or older （elderly group）. [Results]The proportion of female patients in the younger group was significantly higher than that in the elderly group （46.5 % vs. 29.0 %）. The younger group compared with elderly group had a significantly higher proportion of adenocarcinoma （67. 5 % vs. 25.8 % ） and stage Ⅲ～Ⅳ disease （73.6% vs. 59.2%） and significantly lower proportion of squamous cell carcinoma （16.3% vs 56.5%）. Regarding the selection of therapy, in the younger group, significantly higher proportion of patients underwent surgical therapy and chemotherapy. The older patients frequently received surportive care only. The overall survival between two groups was not significantly different. [Conclusion]The ratio of female and adenocarinoma is higher, the disease is more malignant and developed faster in the younger group than in older one, Patients could get better survival by early diagnosis and active treatment.