1993～2003年辽宁地区入院诊疗的肺癌患者痰细胞学类型及变化趋势的分析

Analysis of tumor cytological types and their variation in sputum from lung cancer patients of out-patient and in-patient from 1993 to 2003 in Liaoning Province

目的：探讨肺癌发病与年龄的关系，为肺癌防治提供依据。方法：采用PAT蓄痰液查瘤细胞方法．分析在中国医科大学附属第一医院门诊和住院的辽宁地区1993～2003年2251例肺癌患者细胞学类型。结果：2251例肺癌患者中，有684例（30．39％）检出瘤细胞，男、女的阳性率分别为32．02％（504／1574）和26．59％（180／677）；684例痰阳性患者中，鳞癌、腺癌、小细胞癌及大细胞癌分别占57．65％、31．77％、8．21％和0．41％。各细胞学类型的变化趋势为：男性腺癌呈下降趋势（r=0．576，P≤0．05），鳞癌呈现下降趋势，但差异无统计学意义；女性腺癌呈上升趋势（r=0．563，P≤0．05），鳞癌呈现下降趋势，r=0．797，P≤0．01。40～79岁人群占所有肺癌患者的92．22％，其中50-79岁占80．55％。结论：鳞癌、腺癌和小细胞癌仍为肺癌的主要类型；女性鳞癌有下降的趋势，男性腺癌也有所下降，但女性腺癌有明显的上升趋势；40～79岁人群是肺癌的易患人群。

OBJECTIVE.. To investigate the tumor cytological types of sputum from lung cancer patients and their variation in recent 10 years and to show the relationship between the age and the prevalence rate of lung cancer. METHODS： By use PAT fixative solution, 2 251 lung cancer patients＇ of out-patient and in-pationt in First Affilia- ted Hospital of China Medical University sputum was collected and stained by HE to identify the tumor cytological types. RESULTS： The positive rate of tumor cells was 30. 39% in sputum of 684 out of 2 251 patients. The positive rates in men and women were 32.02%（504/1 574） and 26.59% （180/677）, respectively. Among 684 positive patients, the proportions of squamous cell carcinoma, adenocarcinoma, small cell carcinoma and large cell carcinoma were 57.65%, 31.77%, 8.21% and 0.41%, respectively. The variation trends were., the proportion of adenocareinoma in men was decreased r= -0. 576, P≤0. 05）, and that of squamous cell carcinoma in men was decreased without statistical significance; in women, the proportion of ad went up with year （r=0. 563,P≤0.05）, and that of squamous cell carcinoma decreased, r= --0. 797,P≤0. 01. In all of patients, 40- to 79-year-old patients was 92.22%, and 50- to 79-years-old patients was 80. 55%. CONCLUSIONS： Squamous cell carcinoma, adenoear- cinoma and small cell carcinoma are principle types of lung cancer. Squamous cell carcinoma in women has the trend of going down by year. Adenocarcinoma in men goes down, but ad in women goes up obviously with the time. The group of 40-to 79-year-old was susceptible to lung cancer