四川地区2008年-2013年3,663例肺癌临床病理特征及流行趋势分析

Clinical Epidemiology and Histological Characteristics of 3,663 Lung Cancer Patients in Sichuan Province from 2008 to 2013

背景与目的肺癌作为全球男女性中致死率最高的肿瘤之一,严重威胁着人类的健康。近些年来,各个地区肺癌的发病率及死亡率也有逐年上升的趋势。本研究旨在分析四川地区肺癌患者的临床病理特征与流行趋势,了解肺癌地区与时间分布特点及差异。方法收集2008年-2013年四川大学华西医院就诊的四川地区肺癌患者,分析川中、川南、川北、川西的患者临床病理特征及流行趋势。结果纳入患者3,663例(川中2,378例,川南469例,川北584例,川西232例)。患者平均年龄59.6岁,各个地区患者平均年龄不同(P<0.001),以川中最大,为61.0岁。患者以男性为主(68.4%),不同地区患者男性构成比存在差异(P=0.014),以川北最高,为73.3%。此外,各个地区的病理类型构成比也存在差异(P=0.014),腺癌和鳞癌都在川西构成比最高,分别为57.8%和30.2%,小细胞癌则在川北构成比最高(19.9%)。2013年腺癌与鳞癌构成比较2008年均有所降低,早期肺癌及淋巴结转移构成比有所上升。此外,不同地区肺癌患者3年生存率不同(P=0.021),以川西最低,仅为13.6%,可能与该地区采用姑息治疗患者比率高相关。结论近六年于我院就诊的四川地区肺癌患者以川中为主,男性多见,中老年为甚,腺癌居多,且腺癌和鳞癌的构成比与六年前相比均有下降,早期肺癌及淋巴结转移构成比上升。不同地区肺癌患者的平均年龄、男性构成比、病理类型及3年生存率均有差异。

Background and objective Lung cancer is the most common malignancy and is the leading cause of cancer-related death worldwide. Thus, this disease severely threatens human health. This study aims to identify the clinical epi- demiology and histological characteristics of lung cancer patients in Sichuan areas. Methods We enrolled 3,761 lung-cancer patients who were identified as residents of Sichuan province and treated in West China Hospital from 2008 to 2013. Results A total of 3,663 patients from Central, Southern, North, and Western areas in Sichuan province, respectively, were enrolled. ＂Ihe average age of patients was 59.6 years, and patients were predominantly male （68.4%）. Significant statistical differences were observed among the average age of patients, male, and pathological types in different regions （all P〈0.0S）. In addition, com- pared with the 2008 group, the 2013 group had lower rates of adenocarcinoma and squamous-cell carcinoma but higher rates of early-stage lung cancer and lymph-node metastasis. After a three-year follow-up of 1,003 cases, results showed that the 3-year overall survival （OS） was not the same in different regions （P=0.021）, and that the poorest OS was in Western Sichuan. This result may be related to the high rate of patients with palliative care. Conclusion For the last six years, the patients with lung cancer in Sichuan were mainly from Central Sichuan, male patients, elder （age 〉 60 yr） patients, and with adenocarcinoma of the lung. Patients of 2013 had lower rates of adenocarcinoma and squamous-cell carcinoma but higher rates of early-stage lung cancer and lymph-node metastasis. Furthermore, the 3-year OS was not the same in different regions.