慢性阻塞性肺疾病合并肺癌的临床特征分析

Clinical characteristics of chronic obstructive pulmonary disease complicated with lung cancer

目的探讨慢性阻塞性肺疾病(COPD)合并肺癌与单纯COPD患者之间临床特征的差异,提高COPD合并肺癌在临床工作中的早期识别及诊断。方法回顾性分析COPD合并肺癌及单纯COPD各48例患者的临床资料,包括年龄、性别、体重指数(BMI)、吸烟史、吸烟指数、临床症状及体征、肺功能、发病部位及病理类型等。采用SPSS22.0统计软件对上述结果进行统计分析。结果COPD合并肺癌患者吸烟指数高于单纯COPD患者(P<0.05);COPD合并肺癌患者出现咯血、消瘦、胸痛等高于单纯COPD患者(P<0.05);COPD合并肺癌以肺上叶多见(64.6%),肺功能分级多为Ⅰ-Ⅱ级(83.3%),且DLCO较单纯COPD显著降低(P<0.01);COPD合并肺癌患者病理类型以鳞癌常见(54.2%)。结论COPD合并肺癌多发生于男性吸烟者,以鳞癌常见,肺上叶发生率高,COPD患者出现咯血、消瘦、胸痛等临床症状及DLCO较前明显下降时应高度警惕肺癌的发生。

Objective To explore the difference of clinical features between chronic obstructive pulmonary disease(COPD)complicated with lung cancer and simple COPD,so as to improve the early recognition and diagnosis of COPD complicated with lung cancer in clinic.Methods The clinical data of 48 patients with lung cancer and COPD alone were retrospectively analyzed,including age,sex,body mass index(BMI),smoking history,smoking index,the clinical symptoms and signs,pulmonary function,site and pathological type.The clinical data were analyzed by SPSS 22.0.Results The smoking index of COPD patients complicated with lung cancer was higher than that of COPD patients only(P<0.05).The incidence of hemoptysis,emaciation and chest pain in COPD patients complicated with lung cancer was higher than that in patients only with COPD(P<0.05).COPD complicated with lung cancer was mostly seen in the upper lobe(64.6%),and the pulmonary function classification was mostly I-II(83.3%),and DLCO was significantly lower than COPD only(P<0.01).The pathological type of lung cancer with COPD was squamous cell carcinoma(54.2%).Conclusion COPD complicated with lung cancer mostly occurs in male smokers.Squamous cell carcinoma is common,and the incidence of lung cancer is high in the upper lobe.The patients with COPD should be highly alert to the occurrence of lung cancer when their clinical symptoms such as hemoptysis,emaciation,chest pain and DLCO decrease significantly compared with the previous ones.