8081例原发性肺癌临床特征分析

Analysis of the clinical characteristics of 8 081 primary lung cancer

目的根据大样本临床数据,了解原发性肺癌患者的临床病理分型特点.方法回顾性收集中国6个省份16家医院于2012—2013年间首次诊断为原发性肺癌患者的个人信息、危险因素信息以及病理分型等临床信息,比较不同病理分型在性别、年龄组及出生队列中的分布特点.结果8 081例肺癌患者中,男性5 422例(67.10%),女性2 659例(32.90%);发病年龄为(60.96±10.14)岁.在肺癌患者的病理类型中,腺癌比例最高,占53.13%,其次为鳞癌(24.51%)、小细胞癌(14.59%)和大细胞癌(0.66%),占肺癌所有病理分型的92.89%.鳞癌患者吸烟率最高(62.45%),腺癌患者吸烟率最低(29.68%).男性患者人数明显高于女性,性别比例为2.04 ∶ 1;其中鳞癌男女比最高,为9.14 ∶ 1;腺癌男女比最为接近,为1.14 ∶ 1.男性肺癌患者中的病理分型分布情况与总体一致,女性肺癌患者中,腺癌所占比例最高(75.42%),其次为小细胞癌(10.08%)、鳞癌(7.34%)和大细胞癌(0.39%).出生越晚的肺癌患者腺癌比例更高,而鳞癌所占比重较低(P<0.0001).结论腺癌为肺癌患者最主要的病理分型,且肺癌病理分型在性别、年龄组、出生队列间的分布特点不同.

Objective To characterize the clinical epidemiological features of primary lung cancer patients based on massive clinical data. Methods The demographic and histological information of 8 081 primary lung cancer patients who were initially identified from 1 January 2012 to 31 December 2013 in 16 hospitals from 6 provinces were retrospectively analyzed to determine the characteristics of different histological subtypes among different gender, age-group and birth cohort. Results Among the 8 081 lung cancer patients, 5 422 (67.10%) were male and 2 659 (32.90%) were female, the average age was (60.96±10.14) years. The most common histological subtypes of lung cancer successively were adenocarcinoma (ADC), squamous cell carcinoma (SCC), small cell carcinoma and large cell carcinoma, and the proportions of these subtypes were 53.13%, 24.51%, 14.59% and 0.66%, respectively, which collectively accounted for 92.89%. The current highest smoking rate was observed in SCC patients, which was 62.45%, while lowest in ADC, which was 29.68%. The incidence of lung cancer in male was significantly higher that that of female, with a sex ratio of 2.04∶1. The highest sex ratio was observed in SCC, which was 9.14∶1, while lowest in ADC, which was 1.14∶1. The distribution of histological subtypes in male lung cancer patients was consistent with the general situation.While among the female lung cancer patients, the proportion of ADC was the highest (75.42%), followed by SCC (10.08%), squamous cell carcinoma (7.34%) and large cell carcinoma (0.39%). Analyzed by the birth cohort, the proportion of ADC gradually increased with the age, while the reduced tendency was observed in SCC (P<0.000 1). Conclusion Adenocarcinoma is the most important histological subtype of lung cancer, and the distribution characteristics of histological subtypes of lung cancer differs among genders, age and birth cohort.