老年肺癌患者的临床特点及支气管镜表现

Clinical characteristics and bronchoscopy features in elderly patients with lung cancer

目的：探讨老年肺癌患者的临床特点及支气管镜表现。方法：回顾分析416例经支气管镜确诊的老年肺癌患者（年龄≥60岁）的临床资料及支气管镜检查结果,并与327例非老年肺癌患者（年龄〈60岁）进行对比分析。结果：老年肺癌患者男女比例是3.9：1,中位年龄是68岁,咯血症状显著多于非老年患者（P〈0.05）。鳞癌最多见,占50.5%,显著多于非老年（P〈0.01）;其次是小细胞癌,占19.7%,显著少于非老年（P〈0.01）。支气管镜下以增生型病变最多,占72.1%（300/416）,其次是浸润型,占21.9%（91/416）。老年增生型的鳞癌最多见,占42.8%（178/416）,显著高于非老年患者（P〈0.05）。肺CT显示的病变部位与支气管镜检查结果的符合率是54.2%~77.4%。结论：老年肺癌患者的临床症状、病理分型及支气管镜下表现与非老年肺癌患者存在差异;支气管镜检查是临床上诊断老年人肺癌的重要手段。

Objective：To explore the clinical characteristics and bronchoscopy features of elderly patients with lung cancer.Methods：A total of 416 elderly patients（age over 60 years）of lung cancer diagnosed with bronchoscopy and 327 young and middle-aged patients of lung cancer were analyzed retrospectively.The correlations among the histopathologic type of lung cancer,chest CT scan,symptom,gender and the features under bronchoscope were investigated.Results：Of the elderly patients,the male/female ratio was 3.9/1,and the median age was 68.The number of elderly patients with hemoptysis was higher than that of young and middle-aged group（P0.05）.The pathological types included squamous cell carcinoma（n=210,50.5%）,small cell lung cancer（n=82,19.7%）and adenocarcinoma（n=71,17.1%）.Among the patients with squamous cell cancer,elder was significantly more than young and middle-aged group（P0.01）.While among the small cell lung cancer,elder was significantly lower than young and middle-aged group（P0.01）.Under bronchoscope,the cases consisted of proliferative neoplasm（n=300,72.1%）,infiltration（n=91,21.9%）in elderly patient with lung cancer.Most lesions were found in elderly patients with squamous cell carcinoma of neoplasm（n=178,42.8%）that was significantly more than young and middle-aged group（P0.05）.The conformity range of CT and bronchoscopy was 54.2%~77.4% in elderly patients of lung cancer.Conclusion：The number of elderly patients with squamous cell carcinoma of neoplasm is higher than that of young and middle-aged people,and bronchoscopy plays an important role in the diagnosis of lung cancer in elderly patients.