摘要
目的探讨慢性阻塞性肺疾病(COPD)合并肺癌的临床特征,为肺癌的早期诊断及治疗创造最佳时机。方法采用病例对照研究,回顾性分析122例COPD合并肺癌患者,匹配年龄、性别后选择同期收治的124例单纯肺癌患者为对照组,记录二组患者的性别、年龄、体重指数(BMI)、吸烟史、吸烟指数,肺癌的临床症状、病理类型、分期、肺功能指标、确诊方法、治疗方法及化疗效果等资料,采用SPSS13.0统计软件对上述结果进行统计分析。结果 COPD合并肺癌组年龄、性别、BMI较单纯肺癌组无统计学差异(P>0.05),吸烟者中COPD合并肺癌组(均数910.8支/年)吸烟指数明显高于单纯肺癌组(均数764.7支/年)(P<0.05);吸烟COPD合并肺癌患者中,病理类型为腺癌患者(均数46.8%)第一秒用力呼气容积占预计值百分比(FEV1.0%pred)明显低于鳞癌(均数54.7%)和小细胞肺癌患者(均数58.0%)(P<0.05);COPD合并肺癌组中央型肺癌83例,占68.0%,病理类型以鳞癌(49.2%)为主,与单纯肺癌组比较差异有统计学意义(P<0.05)。结论 COPD合并肺癌组患者以中央型鳞癌较为常见,确诊时以Ⅲ、Ⅳ期为主,临床特征缺乏特异性,早期诊断困难。
Objective To investigate the clinical features of chronic obstructive pulmonary disease （COPD） complicated with lung cancer （LC）, and to optimize the early diagnosis and treatment in the coexistence of COPD and lung cancer. Methods Through a retrospective case-eontral study, the data of clinical-pathological itfformation were collected from 122 patients of COPD complicated with newly diagnosed LC （COPD-LC group）, and 124 non-COPD patients of LC （LC group） that matched age and gender as control group. These clinical data （sex, age, BMI, Smoking history, Smoking Index, the clinical symptoms of lung cancer, pathological type, classification, lung function, diagnostic method, treatment, chemotherapy and so on） were analyzed using the SPSS 13.0. Results There were no significant difference in age, sex, BMI between COPD-LC and LC group respectively （ P 〉 0.05 ）. The smoking index in COPD-LC group （ mean 910.8 ） was higher than that of LC group （ mean 764.7） （P 〈 0.05）. In COPD-LC group, FEV1.0% pred was lower in patients with adenocarcinoma （ mean 46.8% ） than squamous carcinoma （ mean 54.7% ） and small cell lung cancer （ mean 58.0% ） （ P 〈 0.05 ）. There were significant difference in types and pathological types between COPD-LC and LC group, the most frequent anatomical type was central type, 83 cases （68.0%） and the most frequent histological type was squamous carcinoma in COPD-LC group （ 49. 2% ） （ P 〈 0.05 ）. Conclusion The central squamous cell carcinoma is the most frequent type in patients with COPD-LC. Most of them were identified in late-stage （stage Ill-IV ） when the diagnosis of lung cancer was confirmed. Lack of specific clinical symptoms might delay the early diagnosis of lung cancer among patients with COPD.
出处
《中华肺部疾病杂志（电子版）》
CAS
2015年第1期25-29,共5页
Chinese Journal of Lung Diseases(Electronic Edition)
基金
国家自然科学基金面上项目(81370139)
关键词
肺疾病
慢性阻塞性
原发性支气管肺癌
对照研究
Chronic obstructive pulmonary disease
Lung cancer
Retrospective case-control analysis
