我院近10年肺癌外科治疗患者疾病谱改变研究

Research of changes in surgery for patients with lung cancer disease for during recent 10 years

目的观察我院肺癌外科治疗患者疾病谱的演变趋势,探讨肺癌组织学类型在性别方面的分布差异和非小细胞肺癌各期变化趋势。方法回顾分析2004年至2013年10年间在我院接受手术治疗的肺癌患者资料,收集统计患者年龄、性别、TNM分期、手术方式、病理类型等,分析在不同年份、性别间的差异。结果手术治疗肺癌患者共1750例,组织学类型方面,腺癌上升迅速,已成为最常见的肺癌类型,2004年时其仅占24.29%,到2013年则快速增长至48.83%(χ2=38.233,P<0.01);鳞癌则呈现下降趋势,从2004年时69.39%下降至47.27%(χ2=72.914,P<0.01)。不同性别方面,男性鳞癌占比例最大,但也显现出下降趋势,由63.39%降到42.27%(P<0.01),腺癌则由23.89%增长至37.62%(P<0.01);女性腺癌最多,由2004年49.86%增至2013年78.52%(P<0.01)。手术治疗的非小细胞肺癌各期趋势不同,Ⅰ期由28.57%增加至49.21%(P<0.01),除Ⅰ期外,Ⅱ期、Ⅲ期、Ⅳ期都呈现为下降趋势。结论接受手术治疗的肺癌患者人数明显增长,肺癌患者组织学类型及非小细胞肺癌分期分布变化明显。

Objective To observe the trend of surgery for lung cancer patients,and to investigate the trend of lung histologic types in terms of gender differences and non-small cell lung cancer at different stages. Methods The clinical data of patients with lung cancer accepted surgery in our hospital from 2004 to 2013 were retrospectively analyzed. The statistics of patients in many aspects were collected,such as age,sex,TNM staging,surgical approach,pathological type and seat of registered permanent residence. Results 1750 patients with lung cancer received surgical treatment. For histologic types,adenocarcinoma rised rapidly and had become the most common type of lung cancer,which accounted for only 24. 29% in 2004 and up to 48. 83% in 2013（ chi-square = 38. 233,P〈0. 01）. Squamous cell carcinomas showed a trend of decline,from 69. 39% in 2004 to 47. 27% in 2013（ chi-square= 72. 914,P〈0. 01）. For the aspect of gender,the male squamous carcinoma accounted for the largest proportion,but it also showed a downward trend,from 63. 39% to 42. 27%（ P〈0. 01）. The male adenocarcinoma increased from 37. 62% to 23. 89%（ P〈0. 01）. The female adenocarcinoma increased from 49. 86% in 2004 to 78. 52% in2013（ P〈0. 01）. The trend of surgical treatment for NSCLC） was different,which showed a increase from 28. 57%to 28. 57% at stage Ⅰ（ P〈0. 01）. Conclusion The number of patients with lung cancer receiving surgical treatment is increasing,and the distribution of patients with lung cancer in histological types and non-small cell lung cancer staging have obvious changes.