支气管肺癌合并慢性阻塞性肺疾病的临床研究

目的：探讨慢性阻塞性肺疾病（COPD）合并支气管肺癌的临床特点、早期诊断方法。方法：对76例肺癌合并COPD患者发病年龄、性别、临床表现进行回顾性分析。结果：76例患者中男49例（64．5％），女27倒（35．5％）。病理类型：蚌癌25例（32．9％），腺癌23例（30．2％），小细胞癌3例（3．9％），未定型癌13例（17．1％）。TNM分期：Ⅰ期26例（34．2％），Ⅱ期12例（15．7％），Ⅲa＋b期29例（38．2％），Ⅳ期9例（11．8％）。结论：肺癌合并COPD患者的症状无特异性，早期确诊率低。男女性患者的临床表现、病理类型不同。警惕COPD患者胸痛、血痰、咳嗽性质的改变，定期X线筛查有助于早期发现。

Objective To explore clinical feature and early peroid diagnosis of chronic obstructive pulmonary disease （COPD） mergered primary bronchogenic carcinoma Methods We reviewed 76 patients with COPD mergered lung cancer, including age, sex, clinical feature and early peroid diagnosis. Results Of the 76 patients in the study, 49 patients（64. 5%）were men and 27patients （35.5 % ） were women. Pathologic examination showed 25 cases of squamous cell carcinoma（32.9 %）, 23 cases of acinic cell carcinoma（30.2%）,3 cases of small cell carcinoma（3.9%）,and 13 cases were not confirmed（17. 1%）. Conclusions There were no specific symptoms in the patients with primary bronchogenic carcinoma mergered COPD, so early peroid diagnosis rate was very low. We noticed the differences of the clinical feature and pathologic type between men and women. The change of cough quality,chest pain and sputum blood of Patients with COPD should alert possibility of mergered lung cancer. Regular check of radiology may be of value in early diagnosis.