慢性阻塞性肺疾病合并肺癌患者的临床特征研究

Clinical Features of Patients with Chronic Obstructive Pulmonary Disease and Lung Cancer

目的探索慢性阻塞性肺疾病(COPD)合并肺癌患者的临床特征,并筛查COPD患者发生肺癌的临床危险因素。方法回顾性分析河南省人民医院2021年3月至2022年7月收治的70例COPD合并肺癌患者(观察组)和同期住院的72例单纯COPD患者(对照组)的临床资料,包括性别、年龄、吸烟史、吸烟指数、临床表现、实验室检查等数据。比较两组的临床资料,并进一步寻找影响COPD合并肺癌发生的危险因素。结果观察组咯血、消瘦、胸痛、肺不张、胸腔积液等症状的发生率,以及中性粒细胞计数、嗜酸性粒细胞计数、血小板计数及C反应蛋白水平均高于对照组,血红蛋白低于对照组(P<0.05);观察组吸烟患者占比、吸烟指数>400支·a^(-1)的患者占比、男性患者占比均高于对照组,观察组>60岁患者占比低于对照组,差异均无统计学意义(P>0.05);COPD合并肺癌确诊方式以气管镜活检为主(64.29%),病变部位以右肺为主(52.86%),病理类型以鳞癌及腺癌为主(85.71%),TNM分期以Ⅲ/Ⅳ期为主(84.29%),初次确诊时大部分患者已发生转移(84.71%)。结论COPD合并肺癌患者的临床特征为咯血、消瘦、胸痛、阻塞性肺不张、胸腔积液等症状,且血液指标,尤其是血小板和C反应蛋白的变化趋势对COPD合并肺癌的筛查具有指导意义。

Objective To explore the clinical features of chronic obstructive pulmonary disease(COPD)complicated with lung cancer,and to screen patients with COPD for the clinical risk factors of lung cancer.Methods The clinical data of 70 patients with COPD complicated with lung cancer(observation group)and 72 patients with simple COPD(control group)admitted to Henan Provincial People’s Hospital from March 2021 to July 2022 were retrospectively analyzed,including gender,age,smoking history,smoking index,clinical manifestations,laboratory tests and other data.Compared the differences between the two groups in the above clinical data,and to further search for risk factors affecting the occurrence of COPD and lung cancer.Results The incidence of hemoptysis,weight loss,chest pain,atelectasis,pleural effusion and other symptoms in the observation group,as well as neutrophil count,eosinophil count,platelet count and C-reactive protein were higher than those in the control group,and the hemoglobin was lower than that in the control group(P<0.05).The proportion of smoking patients,smoking index>400 bottles every year,and male patients in the observation group were higher than those in the control group,the proportion of patients aged>60 years were lower than that in the control group,and the difference was not statistically significant(P>0.05).COPD combined with lung cancer was mainly diagnosed by tracheoscopic biopsy(64.29%),the lesion site was mainly the right lung(52.86%),the pathological type was mainly squamous cell carcinoma and adenocarcinoma(85.71%),the TNM stage was mainly stageⅢ/Ⅳ(84.29%),and most patients had metastasis(84.71%)at the time of initial diagnosis.Conclusion The clinical features of patients with COPD and lung cancer are hemoptysis,weight loss,chest pain,obstructive atelectasis,pleural effusion and other symptoms,and the change trend of blood indicators,especially platelets and C-reactive protein,has guiding significance for the screening of COPD combined with lung cancer.