铜川市煤矿工人肺癌的影像学特征及流行病学分析

Imaging Features and Epidemiology of Lung Cancer among Coal Miners in Tongchuan City

目的讨论铜川市煤矿工人肺癌的影像学特征及流行病学分析。方法选取2008年4月-2018年4月期间,在铜川矿务局中心医院诊治的180例煤矿工肺癌患者及同时期40例非煤矿工肺癌患者为研究对象,统计所有患者人口社会学资料、工龄、肿瘤分期等基础资料,采用胸部CT及MRI等影像检查,分析所有患者的影像学特征。结果煤矿工肺癌与非煤矿工肺癌患者在年龄、是否吸烟、肿瘤分期、是否淋巴结转移相比差异无统计学意义(P>0.05),煤矿工肺癌与非煤矿工肺癌患者并发尘肺病发生率相比差异具有统计学意义(P<0.05)。经过影像学检查,发现煤矿工肺癌患者中周围型肺癌的占比略高于非煤矿工肺癌患者,但两组相比差异无统计学意义(P>0.05),同时煤矿工肺癌影像学特征为病灶点钙化及胸膜凹陷征占比明显高于非煤矿工肺癌患者(P<0.05),但煤矿工肺癌患者与非煤矿工肺癌的毛刺征及分叶征占比差异无统计学意义(P>0.05)。经术后病理检查或组织活检发现煤矿工肺癌与非煤矿工肺癌患者的病理类型分布无显著差异(P>0.05),但煤矿工肺癌患者中鳞癌的占比明显高于非煤矿工肺癌患者(χ~2=4.077,P<0.05)。结论煤矿工肺癌患者并发尘肺病的发病率较高,且周围型肺癌占比较高,其中以病灶点状钙化、胸膜凹陷征等影像学特征为显著特点。

Objective To study the imaging characteristics and epidemiology of lung cancer among coal miners in Tongchuan.Methods One hundred and eighty coal miners with lung cancer and forty non-coal miners with lung cancer diagnosed and treated in the Central Hospital of Tongchuan Mine Bureau between April 2008 and April 2018 were selected as subjects. The social and demographic data,length of service,tumor staging and other basic data of all the patients were statistically analyzed.Their imaging features were analyzed by X-ray and MRI. Results There was no significant difference in age,exposure to smoking,tumor stage or lymph node metastasis between coal miners and non-coal miners with lung cancer（ P〉0.05）.The difference in the incidence of pneumoconiosis between coal miners with lung cancer and non-coal miners with lung cancer was statistically significant（ P〈0. 05）. After imaging examination,it was found that the proportion of peripheral lung cancer in coal miners was slightly higher than that in non-coal miners,but there was no significant difference between the two groups（ P〉0. 05）. At the same time,such imaging features as focal calcification and pleural indentation were more common in coal miners than in non-coal miners（ P〈0.05）,but there was no significant difference in the proportion of burr signs and lobulation signs between the two groups（ P〉0.05）. By pathological examination or biopsy,it was found that there was no significant difference in the pathological type of lung cancer between coal miners and non-coal miners（ P〉0.05）,but the proportion of lung squamous cell carcinoma in coal miners was significantly higher than that of non-coal miners（ χ^2= 4.077,P〈0.05）.Conclusion The incidence of lung cancer complicated with pneumoconiosis in coal miners is relatively high,so is the incidence of peripheral lung cancer. Focal spot calcification and pleural depression are the prominent imaging features.