118例青年肺癌临床分析

Clinical analysis of 118 young patients with lung cancer

目的探讨青年肺癌临床特点。方法对复旦大学附属华山医院资料完整的118例青年肺癌患者进行分析。结果男女比例4.6∶1,73.7%患者有吸烟史,41.3%患者20岁前吸烟。咳嗽、痰血、胸痛、气喘和发热是最常见症状。肿块和结节是主要影像学表现。病理类型:腺癌(69.5%),鳞癌(13.6%)及小细胞肺癌(8.5%)。31例腺癌检测EGFR基因突变,67.7%阳性,与性别和吸烟无相关性(P>0.05)。35例手术治疗,67例化疗,8例靶向治疗。结论青年肺癌无特异临床表现。多数患者20岁前开始吸烟。腺癌最为常见,且EGFR基因突变率高,与吸烟和性别无相关性。

Objective To analyze the clinical characters of young patients with lung cancer. Methods The clinical data of 118 young patients with primary lung cancer were retrospectively analyzed. Results The occurrence ratio of male to female was 4. 6 ∶ 1. 87 patients had smoking history （73. 7%）, and 41. 3% of them began smoking before the age of 20. In the majority of patients the clinical presentation were mass （65. 3%） and nodule （15. 3%） on X-ray or CT. The most common symptom was cough （66. 1%）, followed by bloody phlegm （28. 0%）, chest pain （15. 3%）, breathlessness （13. 6%） and fever （9. 3%）. Adenocarcinoma accounted for 69. 5% and was the main＆amp;nbsp;histological type. SCLC accounted for 8. 5%. 31 adenocarcinoma patients were detected for EGFR gene mutation, and 21 （ 67. 7%） cases were positive, which had no relation with sexuality and smoking history （ P〉0. 05 ） . In these patients, 35 of them received operations, 67 got chemo and/or radiotherapy, 8 accepted molecular targeted therapy and 8 refused any treatment. Conclusion Young lung cancer patients have no specially clinical finding on symptoms and chest imaging. Quite a lot of patients begin smoking before 20, but SCLC incidence is low, which needs further study. Adenocarcinoma is the predominant pathological type, and in these cases EGFR gene mutation rate is high and has not significant relationship with gender and smoking status.