胸外科肺癌1695例临床资料分析

目的通过对胸外科收治的原发性肺癌患者临床资料的分析，为肺癌的早期诊断、早期治疗提供经验。方法本研究对1695例本院胸外科肺癌患者的临床资料进行回顾性分析，分析目前胸外科收治患者的高发年龄、危险因素、诊断分期和治疗状况等。结果在胸外科肺癌患者中，男女构成比为2．4：1；患者平均吸烟指数39．80包年，其中男性平均40．62包年，女性平均29．52包年；病理类型分布：腺癌692例（50．47％），鳞癌452例（32．97％），小细胞癌86例（6．27％）；在腺癌中，男性占54．34％，女性占45．66％；在鳞癌中，男性占92．26％，女性占7．74％。肺癌合并COPD者167例（9．85％），其中可行手术者105例，病理诊断鳞癌者最多（45例）；肺癌合并COPD术后并发症发生率为22．86％，30d内死亡率为2．86％，均高于一般患者（15．96％，1．82％）；术后30d内死亡患者26例，约70％为Ⅲ期及以上中晚期患者，影像学分期中央型17例，周围型9例，病理示鳞癌14例，腺癌8例。结论肺癌男性发病率高于女性，这与男性中的高吸烟指数相关，近年肺癌的构成已转变，腺癌目前发生最多，这可能与环境污染相关。COPD合并肺癌患者中，鳞癌居多，且COPD致使术后的高并发症及死亡率。周围型腺癌患者术后死亡率较低，早期的手术治疗对延长肺癌患者生存期至关重要。

Clinical analysis of 1 695 cases of lung cancer in department of thoracic surgery

Objective To analyze the clinical features of lung cancer patients in department of thoracic surgery and provide ideas for early diagnosis and treatment of lung cancer. Methods The retrospective study of 1 695 patients with lung cancer treated in the department of thoracic surgery of Shanghai Ruijin hospital was carried out in order to analyze clinical features. including age. risk factors. diagnosis stage. and curative effect. Results Among the patients, the ratio of male to female was 2. 4 ： 1. The mean smoking index was 39.80 pack-years （40. 62 pack-years in males and 29. 52 pack-years in females）. The pathologic type showed： 692 adenocarcinoma patients （50.47%）,452 squamous cell carcinoma patients （32. 97 %） , 86 small cell lung cancer patients （6.27 %）. Of the adenocarcinoma patients, 54. 34% was male and 45.66% was female, while in the squamous cell carcinoma, 92. 26% was male and 7. 74% was female. The amount of lung cancer patients with chronic obstructive pulmonary disease was 167 （9. 85 %） , in whom 105 patients were candidates for surgery. In these patients, the incidence of postoperative complication （22.86%） and the mortality rate within 30 days （2.86%） were both higher than those in normal ones （15.96 % , 1. 82 %）. 26 patients died within 30 days after the operation, 70 % of whom belonged to stage III or stage N. Among the dead patients, the amount of central lung cancer and peripheral lung cancer patients was 17 and nine. respectively. According to pathological type, the amount of squamous cell carcinoma and adenocarcinoma patients was 14 and eight, respectively. Conclusions Due to long-time smoking, the morbidity of lung cancer in males is higher than that in females. And it is true that the adenocarcinoma has become the most common type of lung cancer. which may be related to environmental pollution. The pathological type is mostly squamous cell carcinoma in the lung cancer patients with chronic obstructive pulmonary disease, in whom the incidence of postoperative complication and mortality are higher. And in the peripheral adenocarcinomama patients, the postoperative mortality is lower. Anyway, timely operation is of great significance for lung cancer patients.