非小细胞肺癌性别差异的临床研究

Clinical research on demography of patients with non-small cell lung cancer

目的分析男性和女性非小细胞肺癌（non-small cell lung cancer，NSCLC）患者年龄、吸烟史、组织病理学类型、临床表现、临床分期及治疗方案等方面的不同。方法回顾性分析上海长征医院2002年1月至2008年6月收治的921例确诊为肺癌的患者，分析男女NSCI。C患者上述各方面的差异，统计学方法选用t检验和z。检验。结果921例NSCLC患者中，男性647例，占70．2％，女性274例，占29．8％。女性确诊NSCLC早于男性[（57．9±11．4）岁VN（60．9±10．9）岁，P〈0．013，且女性腺癌患者的平均年龄亦低于男性腺癌患者[（57．9±11．6）岁vs（59．8士11．1）岁，P=0．041]。男性鳞癌的比例明显高于女性（39．6％vs7．7％，P〈0．01），而女性中腺癌比例高于男性（88．7％vs55．2％，P〈0．01）。在各型NSCLC患者中，男性吸烟的比例均高于女性（鳞癌：86．3％vs9．5％，P〈0．01；腺癌：68．1％vs3．7％，P〈0．01；其他类型NSCLC：76．5％vs0．0％，P〈0．01），男性患者咯血的发生率高于女性（32．5％vs18．6％，P=0．027）。结论NSCLC在男性中更为多发。女性发病早于男性，女性腺癌患者的平均年龄低于男性腺癌患者。男性中鳞癌比例高于女性，而女性中腺癌更为常见。各型NSCLC患者中，男性吸烟的比例均高于女性。

Objective To analyze the difference between male and female patients with non-small cell lung cancer （NSCLC） in age, smoking history, histopathologic types, clinical manifestations, staging status and treatment, etc. Methods The data of 921 patients diagnosed with NSCLC in Shanghai Changzheng Hospital from January 2002 to June 2008 were retrospectively analyzed, statistical methods used were t test and Xz test. Results Of 921 patients with NSCLC,647 patients （70.2 ~/00） were men and 274 patients （29.8O/oo） were women. Women developed the disease at an earlier age than men [-（57.9± 11.4） years old vs （60.9± 10.9） years old, P 〈0.01]. The female patients with adenocareinoma were younger than male patients on average [-（57.9±11.6） years old vs （59.8±11.1） years old, P =0. 041]. The proportion of squamous cell carcinoma in male was higher than that in female （39.6 % vs 7.7 %, P 0.01）, but the proportion of adenocarcinoma in men was lower than that in female （55.2% vs 88. 7%, P 0.01）. In all types of NSCLC, men smoked more intensively than women （squamous cell carcinoma： 86.3% vs 9.5%, P d0.0],adenocarcinoma：68.1% vs 3.7%, P d0.＇0i,other types of NSCLC：76.5% vs 0.0%, P 〈 0.01）. Male patients suffered from hemoptysis more frequently than female patients （32.5% vs 18.6%, P = 0. 027）. Conclusions NSCLC is more frequently in men than that-~n women. Women develope the disease at an earlier age than men. In particular, the female patients with adenocarcinoma are younger than male patients on average. Higher proportion of squamous cell carcinoma but less adenocarcinoma is observed in men than in women. In all types of NSCLC, men smoke more intensively than women.