老年小细胞肺癌患者236例临床分析

Clinical analysis of 236 elderly patients with small cell lung cancer

目的分析老年小细胞肺癌(SCLC)的临床特征。方法回顾性分析236例年龄大于65岁的老年SCLC患者临床资料。结果 236例老年SCLC患者中,经纤维支气管镜确诊111例,CT或超声引导下肺穿刺或纵隔淋巴结穿刺确诊75例,淋巴结穿刺或活检15例,各类手术证实24例,肝穿刺证实5例,其他方法确诊6例。咳嗽是老年SCLC患者最常见表现[118例(50.00%)]。SCLC原发病灶发生于右肺143例,左肺89例,纵隔型肺癌4例。男性SCLC患者位于右肺的比例高于女性患者[62.44%(133/213)vs.43.48%(10/23)](P<0.01)。236例患者中,89.41%的患者神经元特异性烯醇化酶升高,47.46%患者癌胚抗原升高。222例(94.07%)患者确诊后采取以放化疗为主的综合治疗。结论老年SCLC患者基础疾病多,临床表现多样,应充分评估风险后行个体化治疗。

Objective To analyze the clinical characteristics of elderly patients with small cell lung cancer（SCLC）.Methods Clinical data of 236 patients with SCLC aged more than 65 years were restropectively analyzed.Results Of 236 cases,the diagnosis of SCLC was confirmed by fiberoptic bronchoscopy in 111 cases,by CT or ultrasound-guided lung puncture or mediastinal lymph node puncture in 75 cases,by surgery in 24 cases,by liver puncture in 5 cases,and by other methods in 6 cases.Cough was the most common symptom of elderly patients with SCLC[118 cases（50.00%）]. The primary lesions of SCLC located in the right lung in 143 cases,in the left lung in 89 cases,and in the mediastinum in 4 cases.The percentage of SCLC located in the right lung was more in male than that in female[62.44%（133/213）vs.43.48%（10/23）]（P〈0.01）.Of 236 patients,the expressions of neuron specific endase and carcino-embryonic antigen were increased in 89.41% and 47.46%, respectively.A total of 222 cases（94.07%）received chemoradiotherapy-based comprehensive treatment.Conclusion Elderly patients with SCLC have many basic diseases and diverse clinical manifestations.Individualized treatment should be taken after risk assessment.