肺癌合并慢性阻塞性肺疾病临床特征分析

Clinical Characteristics of Lung Cancer Complicated With Chronic Obstructive Pulmonary Disease

目的分析肺癌合并COPD与单纯肺癌患者之间的临床特征,提高临床医师对肺癌合并COPD的认识。方法回顾性分析济宁市第一人民医院呼吸科收住院的原发性肺癌患者210例,分为肺癌合并COPD组及单纯肺癌组,使用统计学方法进行分析并得出结论。结果肺癌合并COPD组患者年龄、吸烟指数大于单纯肺癌组,差异具有统计学意义(P<0.001);肺癌合并COPD组患者≥65岁以及吸烟指数≥400的人数高于单纯肺癌组,差异具有统计学意义(P<0.001);肺癌合并COPD组男性、咯血、呼吸困难、胸痛患者多于单纯肺癌组,差异具有统计学意义(P<0.05);肺癌合并COPD组患者原发肿块以中央型为主,单纯肺癌组以周围型常见,两组间比较差异具有统计学意义(P<0.05);肺癌合并COPD组的肺鳞癌患者多于单纯肺癌组,差异有统计学意义(P<0.05);肺癌合并COPD组临床分期Ⅲ期患者高于单纯肺癌组,差异有统计学意义(P<0.05)。结论年龄≥65岁,男性,吸烟的肺癌患者易合并COPD,肺癌合并COPD组患者临床症状无特异性,当患者出现咯血、呼吸困难、胸痛,胸部CT提示中央型肺癌,病理类型是肺鳞癌时,要注意警惕是否合并COPD。对住院肺癌患者要仔细询问病史,临床应考虑COPD,要行肺通气功能及支气管舒张试验,提高肺癌合并COPD的诊断,并及时给予规范治疗,改善肺癌合并COPD患者预后。

Objective To analyze the clinical features of lung cancer patients with COPD and simple lung cancer,and to improve the clinicians＇ knowledge of lung cancer associated with COPD.Methods Retrospective analysis of 210 cases of primary lung cancer patients in department of respiration in the first people＇s hospital of ji＇ning city,which was divided into two groups：lung cancer with COPD group and simple lung cancer group.Statistical methods were used to analyze and draw conclusions.Results The age and smoking index of the patients in lung cancer with COPD group were higher than those in the simple lung cancer group,the difference was statistically significant（P〈0.001）;lung cancer with COPD group were older than 65 years old and smoking index of more than 400 the number was higher than the simple lung cancer group,the difference was statistically significant（P〈0.001）;lung cancer with COPD group with male,hemoptysis,dyspnea and chest pain were more than simple lung cancer group,the difference was statistically significant（P〈0.05）;The primary mass of the patients in the lung cancer with COPD group was mainly central type,and simple lung cancer group was common in the surrounding type,the difference between the two groups was statistically significant（P〈0.05）;The patients with lung squamous cell carcinoma in lungcancer with COPD group were more than simple lung cancer group,the difference was statistically significant（P〈0.05）;The clinical stage and stage III of the patients in the lung cancer with COPD group were higher than those in simple lung cancer group,the difference was statistically significant（P〈0.05）.Conclusion 65 years of age or older,male,smoking lung cancer patients complicated with COPD,no specific clinical symptoms in patients with lung cancer patients in the COPD group,when patients with hemoptysis,dyspnea,chest pain,chest CT showed central lung cancer,pathological type is squamous cell carcinoma of the lung,to watch with COPD.For hospitalized patients with lung cancer must carefully inquire the medical history,clinical COPD should be considered for pulmonary function and bronchial dilation test,improve the diagnosis of lung cancer complicated with COPD,and give the standard treatment to improve the prognosis of patients with lung cancer with COPD.