青少年原发性肺癌外科治疗及预后

Lung cancer in the young adult and prognosis of surgical treatment

目的 :探讨青少年肺癌的特点 ,分析原因 ,总结早期诊断方法。方法 :对 4 8例青少年肺癌进行回顾性统计。结果 :青少年肺癌发病率占本院同期原发性支气管肺癌的 0 97% (48/ 4 90 5例 ) ,误诊率约为 81 2 % (39/ 4 8) ,其中 3例病员误诊时间最长超过 9个月。病理分型以腺癌和鳞癌为主。两者相似比分别为 6 0 4 %和 2 7 0 % ;TNM分期 :中晚期肺癌达 93 7% ;术后死亡率为 2 0 % ,术后一年生存率为 6 2 5 % ;三年生存率为 4 5 8% ;五年生存率为 32 6 % ;七年生存率为 2 7 0 %。结论 :(1)青少年肺癌以误诊率高 ,恶性程度高 ,进展快 ,转移率高 ,手术切除率低 ,预后差等为特点。 (2 )普遍误诊原因有 :对青少年肺癌警惕性不高 ,鉴别诊断困难。 (3)应提高对青少年肺癌的认识 ,提倡早期诊断 。

Objective:To explore the feature of young-adult aged lung cancer,analyse the causes of diagnostic errors Methods:48 cases of young-adult aged lung cancer were statistically reviewed Results:Young-adult aged lung cancer incidence accounted for 0 97%(48/4905)in the whole lung cancer in patients;misdiagnostic rate 87 04% The average time before the first medical examination was 4 months;it was over 9 months in 3 patients Pathologic typing were mainly lung adenocarcinoma and squamous cell carcinoma,and their constituent ratio were 60 4% and 27% respectively Middle and late lung cancer of TNM staging accounted for 93 7% The death rate of the operations was 2% Upon follow up the 1-,3-,5- and 7-,year survival rates were 62 5%,45 8%,32 6%,27% respectively Conclusion:(1)Young-adult aged lung cancer had feature by high rates of misdiagnosis,malignization,quick progression and transition,low rate of operation and resection,unfavorable prognosis etc (2)The reasons for misdiagnosis were unawareness of young-adult aged lung cancer;difficulty in diagnosing (3)The doctors should improve the knowledge on young-adult aged lung cancer,earlier diagnosis and treatment