368例吸烟肺癌患者临床特点与生存分析

Clinical characteristics and survival analysis of 368 cases of smoking lung cancer patients

目的探讨总结吸烟肺癌患者的临床特点及其对生存的影响。方法回顾性分析368例吸烟肺癌患者的临床资料，分析患者的年龄构成、性别比例、组织学分型、临床分期、治疗方法及中医分型等临床指标，分析各指标对生存的影响。结果368例吸烟肺癌患者中，50～69岁为69．84％；男女比例为7．98：1；鳞癌比例高达52．45％；小细胞肺癌广泛期患者达75．38％；非小细胞肺癌Ⅲ、Ⅳ期患者达．82．77％；非手术者达76．36％；中西医结合治疗者占41．04％；气阴两虚型及热毒炽盛型较多见，分别为36．96％、29．28％。性别、组织学分型、中医分型对生存预后影响不明显，而年龄（F=10．356，P=0．000）、临床分期（F=11．289，P=0．000）、治疗方法（t＝2．624，P=0．021）、吸烟指数（F=3．681，P=0．021）对生存预后有影响。结论368例吸烟肺癌患者发病多集中在50～69岁，男性、鳞癌为多，就诊时多为中晚期，非手术治疗为主，且年龄、临床分期、治疗方法与吸烟指数可影响患者生存预后。

Objective To discuss the clinical characteristics and the relationship with the survival of smoking lung cancer patients. Methods The clinical data of 368 cases were retrospectively analyzed by com- paring the differences of the age, gender, histological type, clinical stage, treatment and tradition Chinese med- icine typing, and their correlation with the survival was analyzed. Results Among the 368 patients, the ones aged between 50 to 69 accounted for 69.84% ; the proportion between the male ones and the female ones was 7.98 ： 1 ; the proportion of the squamous cell carcinoma was as high as 52.45% ; the proportion of the patients with small cell lung cancer in extensive stage was significantly higher than that of the patients in the limited stage（75.38% ： 24.62% ） ; the numbers of the patients with non-small cell lung cancer in stage Ⅲ and Ⅳ was significantly higher than that in the stage Ⅰ and Ⅱ（82.77% ： 17.23% ） ; the ones with non-surgical treatment accounted for 76.36%, and the proportion of ones with surgery treatment was 23.64% ; most of the patients were treated by both Chinese medicine and chemotherapy（41.04% ） ; the main types of all patients were qi-yin deficiency syndrome and toxic heat flourishing syndrome, accounting for 36.96% and 29.28% respectively. The age （ F = 10.356, P = 0. 000）, clinical stage （ F = 11. 289, P = 0.000）, treatment methods （ t = 2. 624, P = 0. 021 ）, smoking index（ F = 3. 681, P = 0.021 ） were the key factors effecting the survival （P 〈 0.05 ）, and the gender, histological type, tradition Chinese medicine type had no significant effect（P 〉 0.05）. Conclusion The clinical characteristics of the cases are 50-69 aged, male, squamous cell carcinoma, advanced stage, treatment without surgery. The survival of smoking lung cancer patients is effected by the age, clinical stage, treatment methods and smoking index.