低龄肺癌患者临床及病理特征分析

Clinical and Pathological Characteristics of Lung Carcinoma in Young Adults

目的探究低龄肺癌患者临床及病理特点，达到提高早期诊疗水平的目标。 方法选取2008年1月1日-2014年12月31日首诊于四川大学华西医院的低龄（18~35岁）肺癌患者129例，收集其临床病理资料进行回顾性分析。并与同时期内手术证实为肺部良性占位的32例低龄患者进行临床病理特征对比分析。 结果129例低龄肺癌患者中男57例，女72例；病理类型以腺癌为主（88例），其次为小细胞癌（18例）、鳞癌（13例）及其他类型肺癌（10例）；41例（31.8%）患者因顽固性干咳就诊，另40例（31.0%）患者表现为咳嗽伴咳痰；29例（22.5%）患者首诊时有误诊情况。当低龄肺癌患者被初次诊断时，55.8%的患者已为Ⅳ期，伴远处转移。与肺部良性占位癌组相比，肺癌组患者更容易出现干咳（P=0.011）、胸闷气紧（P=0.007）、体质量减轻（P=0.007）的症状；而肺部良性占位组患者更易出现发热（P=0.040）；咳嗽咳痰、咯血症状在两组中比较差异无统计学意义（P＞0.05）。 结论低龄肺癌患者早期症状轻微且不典型，很容易误诊为其他疾病而耽误诊断治疗。

ObjectiveTo explore the clinical and pathological characteristics of lung carcinoma in young adults, and improve the early diagnosis and treatment. MethodsWe retrospectively analyzed 129 patients with lung carcinoma aged from 18 to 35 years old who came to West China Hospital of Siduan University from January 1st 2008 to December 31st 2014.Also we collected 32 young adults with lung benign mass to make the comparison of the clinical and pathological characteristics with the patients. ResultsIn the 129 patients with lung carcinoma, there were 72 females and 57 males.Adenocarcinoma （88/129） was the most common type of pathology, while others included small cell carcinoma （18/129）, squamous cell carcinoma （13/129）, and other types of carcinoma （10/129）.Among patients with lung carcinoma, 41（31.8%） complained of refractory dry cough and another 40（31.0%） presented coughing and expectoration.Twenty-nine patients （22.5%） were misdiagnosed in their first visits.In young adults with lung carcinoma, 55.8% were at the Ⅳ stage with metastasis at the first-time diagnosis.Comparing with patients with benign lung mass, patients with lung carcinoma presented significantly more dry cough （P=0.011）, chest distress （P=0.007） and weight loss （P=0.007）;while fever was found more patients with lung benign mass （P=0.040）.The differences in cough, expectoration, and emptysis between the two groups were not significant （P 〉 0.05）. ConclusionsLung carcinoma in young adults often has atypical clinical presentations.Therefore, it is more commonly misdiagnosed.