宁夏地区2000—2014年肺癌构成比变化分析

Investigation of Dynamic Constituent Ratio Changes of Lung Cancer in Ningxia,2000-2014

目的了解肺癌构成比的动态变化,及肺癌的部分流行病学特点。方法收集宁夏医科大学总医院2000年1月至2014年12月经组织病理学或细胞学确诊为肺癌的住院患者,分析中央型肺癌与周围型肺癌构成比变化、不同病理类型构成比变化及肺癌在性别、发病年龄、吸烟等方面的变化趋势。结果确诊的肺癌有3 608例,中央型肺癌(CLC)2 081例(57.68%),构成比呈下降趋势(P=0.000)。周围型肺癌(PLC)1 527例(42.32%),呈上升趋势(P=0.000)。其中鳞癌(SCC)构成比由2000—2004年的61.12%降至2010—2014年的38.90%(P=0.000);腺癌(AD)由36.82%升至60.10%(P=0.000)。CLC各病理类型构成比:SCC由63.57%降至42.44%(P=0.000)、AD由14.29%升至28.36%(P=0.000)、SCLC由17.38%升至26.38%(P=0.002)。PLC各病理类型构成比:SCC由25.32%降至16.89%(P=0.014)、AD由57.81%升至70.52%(P=0.001)。男性肺癌患者2 519例(69.82%),女性肺癌患者1 089例(30.18%)。男性肺癌发病人数构成比由75.80%降至67.18%(P=0.000),女性由24.20%升至32.82%(P=0.000);男性以SCC最常见,女性以AD最常见,男女患者SCC均呈下降趋势(P=0.000,P=0.000),AD均呈上升趋势(P=0.000,P=0.000)。SCC、SCLC平均发病年龄呈增大趋势(P=0.002,P=0.000),各病理类型均以≥60岁老年人群多见。AD吸烟人数构成比呈下降趋势(P=0.042)。结论CLC构成比呈下降趋势,PLC呈上升趋势。CLC中SCC呈下降趋势,AD及SCLC呈上升趋势。PLC中SCC呈下降趋势,AD呈上升趋势,SCLC无明显变化。NSCLC中SCC呈下降趋势,AD呈上升趋势;SCLC变化无统计学意义。男性肺癌发病人数呈下降趋势,女性呈上升趋势。各病理类型肺癌发病年龄均无年轻化趋势。SCC和SCLC吸烟人数构成比无变化,AD吸烟人数呈下降趋势。

Objective To analyze the constituent ratio changes of lung cancer and part of the epidemiological characteristics. Methods We collected the clinical data of the patients who have been diagnosed as lung cancer by histopathology or cytology in the General Hospital of Ningxia Medical University from January, 2000 to December, 2014. And we analyzed the constituent ratio changes of central lung cancer（CLC） and peripheral lung cancer（PLC）, changes of different pathological types and changes of gender, age and smoking status. Results There were 3 608 cases of lung cancer diagnosed, including 2 081（57.68%） cases of CLCs and 1 527 （42.32%） cases of PLCs. The proportion of CLCs had decreased gradually（P=-0.000） but PLCs had presented a rising tendency （P=-0.000）. Including 1 328（46.13%） cases of squamous cell carcinomas（SCC） and 1 511（52.48%） cases of adenocarcinoma （AD）. but SCC in NSCLC had decreased from 61.12% in 2000-2004 to 38.90% in 2010-2014（P=0.000）. AD had increased from 36.82% to 60.10% （P=0.000）. The proportion of 637（17.66%） cases of small cell lung cancer （SCLC） had no significant difference （P=-0.194）. In CLC, there were 1 039 （49.93%） cases of SCC, 483 （23.21%） cases of AD and 493（23.69%） cases of SCLC. In CLC, the proportions of SCC had decreased from 63.57% to 42.44% （P=0.000）; AD had increased from 14.29% to 28.36% （P=-0.000）; SCLC had increased from 17.38% to 26.38% （P=0.002）. In PLC, the proportions of SCC had decreased from 25.32% to 16.89%（P=0.014）; AD had increased from 57.81% to 70.52% （P=0.001）. There were 2 519（69.82%） male and 1 089（30.18%） female patients. The proportions of male patients had decreased from 75.80% to 67.18% （P=-0.000） but the proportions of female patients had increased from 24.20% to 32.82% （P=0.000）. SCC was more common in men but AD was more common in women. In male and female patients, SCC had a downward trend （P=0.000, P=0.000）, AD was on the rise（P=0.000, P=0.000） . The onset age of SCC and SCLC had showed a trend of increase （P=0.002, P=-0.000）. SCC, AD and SCLC were more common in elderly people（≥ 60 years old）. The constituent ratio of smoking in AD patients had a downward trend （P=-0.042）. Conclusion The proportion of CLC decreases gradually, while PLC presents a rising tendency; in CLC, SCC proportion decreases gradually but AD and SCLC increases obviously; in PLC, SCC proportion decreases gradually and AD increases obviously, while SCLC has no change. In NSCLC, SCC proportion has a downward trend, AD has a rising tendency, while SCLC has no significant difference. The number of male patients decreases but female patients increases gradually. There was no younger tendency in all types of lung cancer. The constituent ratio of smoking patients with SCC and SCLC has no changes while decreases in AD patients.