青年肺癌患者临床特征及发病相关因素分析

Clinical characteristics of young lung cancer patients and factors relevant to its onset

目的分析青年肺癌患者临床特征,并探讨青年肺癌发病的危险因素。方法采用1∶3配比病例对照研究方法,选取2011年1月—2019年6月在解放军第九八八医院呼吸科就诊的青年肺癌患者74例,并分析其临床特征,同时选取在该医院参加体检的健康人群222例进行问卷调查。通过组间比较对青年肺癌的相关危险因素进行单因素分析和多因素logistic回归分析。结果 74例青年肺癌患者中23例(31.08%)早前无明显不适症状,其余51例表现为咳嗽、咳痰、咯血、胸痛、气促、声音嘶哑及体重减轻等非特异性症状。确诊时已有60.81%的研究对象发生不同程度、不同部位的转移。对病理类型分析显示,腺癌占64.86%,比例最大,其次为鳞癌(16.22%),晚期患者占40.54%。经分析发现青年人群体重指数(OR=0.637,P=0.012)、每周食用新鲜水果(OR=0.720,P=0.001)、常食用大蒜(OR=0.208,P=0.008)是青年肺癌发病的保护性因素;癌症家族史(OR=5.064,P<0.001)、经常吸烟(OR=4.121,P<0.001)、被动吸烟(OR=15.658,P<0.001)、长期睡眠不足(OR=2.423,P=0.025)、长期接触粉尘或棉尘(OR=4.001,P<0.001)、住新建或新装修半年内的房子(OR=1.879,P<0.001)、长期精神压抑(OR=3.099,P=0.011)是青年肺癌发病的独立危险因素(均P<0.05)。结论青年肺癌患者临床表现特异性差、恶性程度较高;其发病原因可能是多因素综合作用的结果,因此应针对暴露危险因素的特殊人群采取综合干预措施以防止肺癌的发病。

Objective To analyze the clinical characteristics of young lung cancer patients,and to explore the risk factors for onset of lung cancer in the young.Methods A 1∶3 matched case-control study was conducted.74 young lung cancer patients hospitalized in Department of Respiratory Medicine,the 988 Hospital of PLA from January 2011 to June 2019 were selected,and then analyzed their clinical features.222 healthy persons undergoing physical examination in the same hospital were simultaneously selected to participate in the questionnaire survey.Single-factor analysis and multi-factor logistic regression analysis were performed to identify risk factors related to young lung cancer through intergroup comparison.Results Among the 74 young lung cancer patients,23(31.08%)had no obvious symptoms of discomfort in the early days,and the other 51 showed non-specific symptoms such as cough,expectoration,hemoptysis,chest pain,shortness of breath,hoarseness and weight loss.At the time of diagnosis,60.81%of the subjects had various degrees and different parts of metastasis.According to the analysis of pathological types,adenocarcinoma accounted for the largest proportion(64.86%),followed by squamous cell carcinoma(16.22%)and advanced lung cancer(40.54%).Logistic regression analysis revealed that body mass index(OR=0.637,P=0.012),fresh fruit consumption per week(OR=0.720,P=0.001),and regular garlic consumption(OR=0.208,P=0.008)were protective factors for lung cancer in young people,while family history of cancer(OR=5.064,P<0.001),frequent smoking(OR=4.121,P<0.001),passive smoking(OR=15.658,P<0.001),long-term lack of sleep(OR=2.423,P=0.025),long-term exposure to dust or cotton dust(OR=4.001,P<0.001),living in a house newly built or newly decorated within six months(OR=1.879,P<0.001)and long-term mental depression(OR=3.099,P=0.011)were independent risk factors for lung cancer in young people(all P<0.05).Conclusions Young lung cancer patients had poor clinical specificity and high degree of malignancy.The cause of the disease may be the comprehensive result of multiple factors;and hence,integrated intervention measures targeted on special population exposed to risk factors should be taken to prevent the onset of lung cancer.