中央型肺癌病理类型构成比变迁分析

Investigation of Dynamic Proportion Changes in Histopathological Types of Central Lung Cancer Diagnosed by Fiberopic Bronchoscope

目的调查经支气管镜活检诊断的中央型肺癌组织病理学类型构成比的动态变化。方法通过支气管镜直视下钳夹取病变组织,切片、苏木精-伊红染色行组织病理学诊断,调查1987—2009年的23年间不同病理类型中央型肺癌所占比例的变化。结果自1987年1月-2009年12月,经支气管镜活检确诊中央型肺癌6 916例,其中1987-1991、1992-1996、1997-2001、2002-2006、2007-2009年5个时期分别诊断中央型肺癌320、773、668、2 546、2 609例。5个时期肺鳞癌占全部肺癌的比例分别为61.88%、64.17%、64.82%、57.58%、51.78%。肺腺癌的比例为23.33%、18.50%、16.02%、18.03%、25.41%。小细胞肺癌比例为16.67%、16.69%、17.81%、21.41%、19.97%,其中小细胞肺癌所占比例呈上升趋势(P<0.01)。女性肺癌占同期全部肺癌的比例分别为:在肺鳞癌中为7.07%、8.06%、11.32%、5.39%、7.40%;在肺腺癌中为23.33%、27.27%、31.78%、37.04%、37.71%;在小细胞肺癌中为16.67%、19.38%、13.45%、18.53%、17.66%。女性肺腺癌的比例呈上升趋势(P<0.05)。但23年间肺鳞癌平均诊断年龄为56.07、57.50、56.15、57.70、58.66岁,肺腺癌的平均诊断年龄为53.97、55.97、53.51、55.18、55.72岁,小细胞肺癌的平均诊断年龄为51.42、53.74、53.89、55.00、55.47岁,三大病理类型的肺癌发病并无年轻化趋势。结论小细胞肺癌占全部中央型肺癌的比率呈上升趋势,女性肺癌占全部中央型肺癌的比率特别是女性肺腺癌的发病呈上升趋势。

Objective In the presently study,we investigated the dynamic changes of proportion in histopathological types of central lung cancer（CLC）.Methods The illness tissue was adopted by forceps holder through bronchoscope and histopathological diagnosis was made after paraffin section and hematoxylin-eosin staining.The proportion changes of pathologic classification of lung cancer（LC） from 1987 to 2009 were investigated.Results From Junary,1987 to December,2009,there were 6 916 cases of lung cancer diagnosed by histopathology confirming via biopsy under bronchoscope,including 320,773,668,2 546 and 2 609 patients of lung cancer diagnosed in the periods of 1987-1991,1992-1996,1997-2001,2002-2006,2007-2009,respectively.For these 5 periods of investigating times,the proportions of lung squamous cell carcinoma（LSCC） were 61.88%,64.17%,64.82%,57.58%,51.78%,of lung adenocarcinoma（LA） were 23.33%,18.50%,16.02%,18.03%,25.41%,and of small cell lung cancer（SCLC） were 16.67%,16.69%,17.81%,21.41%,19.97%,respectively.The proportion of SCLC increased rapidly（P0.01）.In the 5 periods according to times as previously,the female account for 7.07%,8.06%,11.32%,5.39%,7.40% in LSCC,23.33%,27.27%,31.78%,37.04%,37.71% in LA,16.67%,19.38%,13.45%,18.53%,17.66% in SCLC,respectively.Ascending trend in proportion was found in female LA（P0.05）.From 1987 to 2009,the average ages at the diagnosed point of 5 groups of LSCC were 56.07,57.50,56.15,57.70,58.66 years old,of LA were 53.97,55.97,53.51,55.18,55.72 years old,and of SCLC were 51.42,53.74,53.89,55.00,55.47.No aging tendency was found in the three main types of LC.Conclusion The incidence rate of SCLC has been rising gradually.The LC incidence in female has been increasing since 1987,especially in female LA.