肺癌合并慢性阻塞性肺病的不同发生率及病理类型临床分析

Clinical analysis of different incidence and pathological types of lung cancer complicated with chronic obstructive pulmonary disease

目的探讨肺癌合并慢阻肺不同发生率及病理类型差异。方法共收集767例首诊原发性肺癌患者,分为肺癌组683例和肺癌合并慢阻肺组84例,统计肺癌合并慢阻肺不同指标相应发生率,用χ^(2)检验分析两组患者在多种情况下病理类型差异,并将非小细胞肺癌分为鳞癌组211例和非鳞癌组436例,应用Logistic回归分析肺癌病理类型为鳞癌的影响因素。结果确诊率、临床诊断率、误诊率、漏诊率、疑似率、拟诊率分别为:10.9%、27.9%、34.5%、26.8%、30.7%和22.9%。职业构成比:农民、行政、化工厂、运输、钢铁/焊工、渔业船厂、毛绒玩具厂、油漆工/理发工、厨师、木工、工地装修分别为:41.67%、15.48%、10.72%、3.57%、4.76%、2.38%、4.76%、3.57%、3.57%、4.76%和4.76%。两组患者在性别、病理类型上比较(P<0.05)。多因素Logistic回归分析显示,有吸烟史和FEV 1%pred<80%是肺癌病理类型为鳞癌的危险因素。结论肺癌合并慢阻肺确诊率低,漏诊、误诊率高,扬州地区以农民、行政、化工厂等职业发生率高,有吸烟史及FEV 1%pred<80%是肺癌病理类型为鳞癌的危险因素。

Objective To explore the different incidence and pathological types of lung cancer complicated with COPD.Methods A total of 767 patients with primary lung cancer at first diagnosis were collected and divided into the lung cancer group(683 cases)and the lung cancer complicated with COPD group(84 cases).The corresponding incidence of lung cancer complicated with COPD was calculated.The difference of pathological types between the two groups was analyzed by chi-square test in many cases.Non-small cell lung cancer was divided into the squamous cell carcinoma group(211 cases)and the non-squamous cell carcinoma group(436 cases).It used Logistic regression to analyze the influencing factors of pathological type of lung cancer as squamous cell carcinoma.Results The rates of definite diagnosis,clinical diagnosis,misdiagnosis,missed diagnosis,suspected diagnosis and proposed diagnosis were 10.9%,27.9%,34.5%,26.8%,30.7%and 22.9%,respectively.The ratio of occupational composition was farmers,administrative,chemical plant,transportation,steel/welder,fishery shipyard,plush toy factory,painter/barber,cook,and woodworker.The rate of site decoration was 41.67%,15.48%,10.72%,3.57%,4.76%,2.38%,4.76%,3.57%,3.57%,4.76%and 4.76%,respectively.There were significant differences in gender and pathological type between the two groups(P<0.05).Multivariate logistic regression analysis showed that smoking history and FEV 1%pred<80%were risk factors for squamous cell carcinoma.Conclusion The diagnosis rate of lung cancer complicated with COPD is low,the rate of missed diagnosis and misdiagnosis is high,and the incidence of farmers,administrative and chemical plants is high in Yangzhou.Smoking history and FEV 1%pred<80%are risk factors for squamous cell carcinoma.