健康体检对老年肺癌患者早期诊断及生存期的影响

Investigation of the early diagnosis and survival time of the elderly patients with lung cancer found in health examination

目的通过分析健康体检中发现的无症状肺癌患者与有症状就诊的肺癌患者不同临床特点,评价体检对早期肺癌诊断和延长生存期的重要性。方法选取近10年在我院体检中发现的无症状老年肺癌患者48例(无症状组)与同期有症状就诊、资料保存完整的75例老年肺癌患者(有症状组)进行临床症状、分期、病理类型、生存时间的比较。结果两组患者年龄比较无统计学差异;无症状组肺泡癌较有症状组明显增多(χ2=9.63,P<0.05),其它病理类型无统计学差异;无症状组肺癌早期诊断率较有症状组明显增高(χ2=4.073,P<0.05),手术治疗率明显高于有症状组(χ2=10.028,P<0.05);无症状组转移率为27.08%(13/48),有症状组转移率为46.67%(35/75),P<0.05;无症状组生存期较有症状组明显延长,前者1年、3年、5年生存率分别为87.34%,70.12%,70.12%,后者分别为80.29%,52.80%,37.74%(P<0.05)。结论体检对肺癌的早期诊断,及时的手术治疗有重要意义,明显延长了患者的生存期。

Objective To investigate the difference in clinical feature and survival rate of the elderly patients, between patients with lung cancer who shows no symptoms in health examination and those having symptoms found in hospital. Methods Retrospective tests were conducted from 2000 to 2009. Fourty-five elderly patients without lung cancer symptom and 75 case with symptom were compared in clinical feature,stage classifications,pathological type and survival expectance. Results There is no significant difference of ages between two groups. The incidence of bronchioloalveolar carcinoma in the patients without symptom is higher than that in patients with symptom（χ2=9.63,P0.05）. There is no significant difference in other pathology types between two groups. The ratio of early diagnosis of lung cancer and surgical resection therapy in no symptom group are clearly higher than those in the symptom group（χ2=4.073,P0.05 andχ2=10.028,P0.05）. The rate of metastasis patients in the no symptom group is 27.08%（13/ 48）while that in the symptom group is 46.67%（35/75）. The survival rate of the 1,3,5-year among the no symptomatic patients were 87.34%,70.12%,70.12%respectively and for symptomatic patients was 80.29%,52.80%,37.74%. No symptomatic group has a longer life expectance than the symptom group P0.05. Conclusions Health examination plays an important role in the early detection and diagnosis of lung cancer. Timely Surgery can prolong the survival life of the patients with early stage of NSCLC .