女性肺癌住院患者的临床特点分析

Analysis on clinical characteristics of female inpatients with lung cancer

目的探讨女性肺癌的发病特点、诊疗手段演变,进一步提高女性肺癌的诊治水平。方法回顾性分析439例女性肺癌住院患者的临床资料。结果 439例女性肺癌患者发病年龄高峰在40～69岁,占78.1%。病理类型以腺癌为主,占58.3%;农民168例,占38.3%;家庭妇女149例,占33.9%。不吸烟的女性患者中以腺癌多见,占59.9%(236/394);鳞癌与小细胞癌分别占19.5%(77/394)、16.5%(65/394)。影像学检查中周围型肺癌占63.3%,以团块影表现居多(39.9%),其次为肺不张合并胸腔积液(23.2%)。气管镜下表现以直接征象(浸润性、增生性改变)为主,占19.1%;鳞癌以增生性表现为主,腺癌则以浸润性为主,两者比较差异有统计学意义(P<0.05)。单纯化疗占25.3%(111/439),单纯手术占24.8%(109/439),放弃治疗占41.4%(182/439)。结论女性肺癌发病年龄以中老年为主,农民、家庭妇女占大多数;病理类型中以腺癌最常见,周围型居多,确诊时多已属中晚期。对于女性肺癌应提高认识,早发现、早诊治。

Objective To investigate the clinical characteristics, the evolution of the diagnosis method in female lung cancer patients, and improve diagnosis and treatment level. Methods By retrospective analysis on the integrated clinical data of 439 female lung cancer inpatients received medical treatment from 2001 to 2008, the data analyzed and compared based on the characteristics of ages, nationality, occupations, diagnostic methods, pathological types, distant metastasis, and treatment methods. Results The study showed that the onset of lung cancer in 439 female patients peaked in the ages of 40 - 69 years old （78.1%）. Patients pathologically based on adenocarcinoma accounted for 58.3% ; farmers accounted for 38.3% （168）, house wives accounted for 33.9% （149）. Non -smoking female patients with lung cancer detected more common, accounted for 59.9% （236/394）, squamous cell carcinoma and small cell carcinoma were respectively 19.5% （77/394） and 16.5% （65/394）. In imaging detected peripheral lung cancer accounted for 63.3%, mostly in mass shadow （39.9%）, followed by atelectasis pleural effusion （23.2%）. Bronchoscope detected direct signs and symptoms （invasive, proliferative changes）, accounting for 19.1% ; squamous cell carcinoma based in proliferative and adenocarci- noma based in invasive. There were significant statistical differences between the two （X2 = 8.131, or 15. 770, P 〈 0.05）. Chemotherapy alone accounted for 25.3% （111/439）, surgery alone accounted for 24.8% （109/439）, and the patients abandoned the treatment accounted for 41.4% （182/439）. Conclusion The probability of the onset of female lung cancer takes its peak in middle and older age. Among the patients, farmers and house wives accounting for the vast majority; of all the pathological types, adenocarcinoma is the most common, mostly peripheral, already in advanced stage when diagnosed. Early detection, early diagnosis and treatments are important and recommended.