130例青年肺癌的临床病理特征

Clinicopathological Characteristics of 130 Cases of Lung Cancer in the Youth

背景与目的青年肺癌病情进展快,及时准确的诊断十分重要。本研究旨在通过探讨青年肺癌的临床和病理特征,为及时诊断提供线索。方法研究纳入1995年-2012年在人民解放军322医院经病理学和细胞学诊断的年龄<40岁的肺癌患者,回顾性分析其性别、年龄、症状、吸烟史、病理类型及分化程度、临床分期及误诊情况。结果本组共130例,占同期所有肺癌的5.2%。其中男性68.5%;36岁-40岁占53.8%。就诊时的症状以咳嗽、痰中带血等局部症状最为常见,非特异性全身表现相对少见;无症状患者约占11.8%。有吸烟史者占63.3%。从出现症状到经病理学或细胞学确诊平均经历3.9个月,其中51.5%在最终确诊前发生过误诊,最常见的误诊为结核。III期/IV期患者占85.4%。原发病灶以右肺上叶和左肺上叶多见;腺癌最为常见;低分化癌占72.3%。结论青年肺癌的临床病理特征具有一定特殊性。对于拟诊为结核的患者,尤其是全身症状不明显的患者,应考虑到肺癌的可能性并行病理学和细胞学检查。无吸烟史不能排除青年肺癌的可能性。

Background and objective It has been proven that lung cancer in the youth exhibited rapid progres-sion, thus timely and accurate diagnosis is crucial. hTe aim of this study is to explore the clinicopathological characteristics of lung cancer in the youth, so as to provide clues for diagnosis. Methods hTe study enrolled patients aged younger than 40 years with lung cancer diagnosed with histology or cytology in our hospital between 1995-2012. We retrospectively analyzed sex, age, symptoms, smoking history, histology, stage and misdiagnosis. Results One hundred and thirty patients with lung cancer in the youth were enrolled, which comprise 5.2%of all cases of lung cancer in that period. Among them, 68.5%were male;53.8%were aged between 36 and 40 years. Common symptoms included cough and hemoptysis, and systematic symptoms were relatively uncommon;and 11.8%showed no symptoms. 63.3%had a smoking history, and the time between initial symp-tom and ifnal diagnosis averaged 3.9 months. hTe misdiagnosis rate was 51.5%, with tuberculosis as the leading misdiagnosis. 85.4%were staged Ⅲ/Ⅳ. Primary lesion otfen located in upper lobes. Adenocarcinoma was the commonest histology, and 72.3%of the whole group was poorly differentiated. Conclusion Lung cancer in the youth showed some special clinicopatho-logical characteristics. Doctors should consider the possibility of lung cancer in patients with seemly diagnosis of tuberculosis, especially in those without symptomatic symptoms, and perform histological or cytological examinations. The absence of smoking history cannot rule out the possibility of lung cancer in youth patients.