青年人肺癌临床特点及手术疗效分析

The analysis of clinical characteristics and surgical outcome about the lung cancer of the young patients

目的探讨青年人（≤40岁）肺癌的临床特点和手术治疗效果，以提高早期诊断水平，提高远期疗效。方法对1998～2004年我院经病理确诊的542例原发性肺癌进行回顾性总结，对其中70例青年人肺癌临床症状、X线表现、吸烟情况、病理类型、肿瘤分期及手术疗效等方面进行分析，并与同期收治的472例（41～74岁）对照组的肺癌患者进行对比。结果青年人肺癌早期症状轻、误诊率高，应注意肺外体征，对烟龄早，两上肺内病灶伴胸痛要尤其重视。本文统计青年人肺癌腺癌居首位（占51．4％），其次为小细胞癌（25．7％）和鳞癌（22．8％）。手术切除率低（44．3％），远期效果差。总体5年生存率（19．4％）低于对照组（48．6％）。其中1年生存率（96．8％）高于对照组（94．6％），3年生存率（45．1％）低于对照组（65．2％）。青年组全肺切除及局部切除5年生存率为零，而对照组分别为17．6％和7．1％。肺叶切除术后生存率好于全肺和局部肺切除。结论掌握青年人肺癌的临床特点是早期诊断的关键，放宽手术指征，提高切除率以获得较好的远期疗效。

Objective To analyze the clinical characteristics and surgical outcome about the lung cancer of the young patients （ age 〈 40） and to enhance early diagnosis and the survival rate of lung cancer in young patients. Methods 542 lung cancer patients were treated in our hospital form 1998 to 2004. Among them 70 patients were young patients. The type of pathology, staging and surgical outcome were analyzed compared with the other patients （41 - 74 years old）. Results The symptoms of young lung cancer patients were mild in the early stage, with high rate of misdiagnosis. Initial symptoms appeared not in respiratory system should be noticed. The patients who have thoracalgia, focus in both superior pulmonary lobes or began smoking earlier, should be paid special attention. Adenoearcinoma was the main histological type of lung cancer in young patients（51.4% ） , which was more than squamous carcinoma（25.7% ） and smallcell carcinoma （22. 8% ）. The rate of excision and survival rate of lung cancer in young patients were low. The five-year survival rate of lung cancer in young patients（ 19.4% ） was different from that of the control group（ 48.6% ）. Conclusion To grasp the characters of young lung cancer was important in making an early diagnosis. The increase in rate of excision might be a key to enhance the survival rate of lung cancer in young patients.