新疆自治区宫颈浸润癌2417例临床流行病学回顾性分析

目的：探讨新疆地区子宫颈浸润癌患者临床流行病学特征。方法：回顾性分析新疆自治区肿瘤医院1995-01～2002—12收治宫颈浸润癌患者2417例，对临床流行病学情况进行分析。结果：宫颈浸润癌人群发病年龄40～60岁（67．7％），各个地区的维吾尔族均为主要的发病人群（78．7％）；发病人群主要集中于农民及家庭妇女；多孕、多产、早婚、早产和多性伴的情况普遍存在。发病后首次就诊多在县、市级医院，首诊确诊率较高（90．8％），但大多缺乏有效的治疗手段。鳞状细胞癌为主要病理类型；分型以外生型及糜烂型为主要类型；早期（Ⅰ期8．4％）患者比例低，而晚期（Ⅱ～Ⅳ期91．6％）患者比例高；单纯放疗患者（68．4％）所占比例较少，而单纯手术及术前、术后放疗患者所占比例（18．55％）略高。南疆地区与东北疆地区患者以及维汉族患者间临床流行病学资料及病理特征差异有统计学意义，P〈0．05。结论：新疆子宫颈癌发病具有鲜明的地域、民族及职业特征，与社会经济情况紧密相关。多孕、多产、早婚、早产及多性伴等高危因素与宫颈癌发病有关。     

新疆自治区宫颈浸润癌2 417例临床流行病学回顾性分析

目的：探讨新疆地区子宫颈浸润癌患者临床流行病学特征。方法：回顾性分析新疆自治区肿瘤医院1995-01～2002—12收治宫颈浸润癌患者2417例，对临床流行病学情况进行分析。结果：宫颈浸润癌人群发病年龄40～60岁（67．7％），各个地区的维吾尔族均为主要的发病人群（78．7％）；发病人群主要集中于农民及家庭妇女；多孕、多产、早婚、早产和多性伴的情况普遍存在。发病后首次就诊多在县、市级医院，首诊确诊率较高（90．8％），但大多缺乏有效的治疗手段。鳞状细胞癌为主要病理类型；分型以外生型及糜烂型为主要类型；早期（Ⅰ期8．4％）患者比例低，而晚期（Ⅱ～Ⅳ期91．6％）患者比例高；单纯放疗患者（68．4％）所占比例较少，而单纯手术及术前、术后放疗患者所占比例（18．55％）略高。南疆地区与东北疆地区患者以及维汉族患者间临床流行病学资料及病理特征差异有统计学意义，P〈0．05。结论：新疆子宫颈癌发病具有鲜明的地域、民族及职业特征，与社会经济情况紧密相关。多孕、多产、早婚、早产及多性伴等高危因素与宫颈癌发病有关。     

青年肺癌105例误诊分析

目的探讨青年肺癌的发病及误诊情况.方法回顾性分析1996～1999年住院病人的临床资料.结果青年肺癌占同期收治肺癌的8.5%,未分化癌占49.5%,青年肺癌中误诊率64.7%.结论青年肺癌中,未分化癌占大多数,恶性程度高,误诊率高,预后差.     

新疆地区676例宫颈癌临床特征分析

目的:探讨近年新疆维吾尔自治区人民医院宫颈癌的发病情况及临床特征,为宫颈癌的有效预防和临床诊治提供科学依据。方法:以我院2009年至2012年收治的676例宫颈癌患者为研究对象,对其一般资料、病理类型、临床分期等进行回顾性分析。结果:676例宫颈癌患者中,维吾尔族患者占大多数,552例(81.6%)。年龄24~85岁,中位年龄50岁,发病高峰是40~49岁组和50~59岁组,分别占33.3%和30.8%。临床大体病理分型上,菜花型居多,占43.79％;病理组织学类型以鳞状细胞癌居多,占95.12％。分化程度以中、低分化为主,分别占38.46%和33.88%。FIGO临床分期中以Ⅲb期为主,占40．5％。民族分组分析发现维吾尔族患者中晚期比例较汉族及其它少数民族高,其他各病理因素间无显著性差异(P＞0.05)。结论:新疆宫颈癌为维吾尔族妇女高发,组织学病理类型以低、中分化鳞状细胞癌多见,中晚期宫颈癌占大多数,维吾尔族晚期比例相对更高,宫颈癌早期诊断有待进一步提高。     

老年人肺癌51例分析

目的：对老年组肺癌与非老年组肺癌的临床特点进行总结，以利提高诊治水平。方法：对我院近5a确诊的5l例老年肺癌患者与32例非老年肺癌患者的临床资料进行回顾性分析。结果：①肺癌发病率为男多于女；②老年组肺癌首发症状多为咳嗽、咯血、胸痛，非老年组肺癌多以非呼吸系统症状如声音嘶哑、吞咽困难为首发症状；③以鳞癌居多的老年组肺癌手术治疗比率较以小细胞癌居多的非老年组肺癌为高，两组肺癌好转率相近似；④n删分期中I期比例较小，且各年龄组均存在一定比例误诊率。结论：早期诊断手段缺乏及减少误诊仍是目前迫切需要解决与重视的课题。     

40岁以下青年肺癌的临床特点与外科治疗

背景与目的 分析40岁以下青年肺癌的临床特点及治疗方法.方法 本文分析了1994-2007年间40岁以下肺癌患者41例.结果 41例患者男性28例,女性13例,男女之比为2.2:1,病理类型中腺癌为19例,鳞癌16例,小细胞肺癌5例,大细胞肺癌1例.误诊率为44%,多误诊为肺结核,肺炎,炎性假瘤及结核性胸膜炎等.结论 青年肺癌在病理类型上腺癌多见,故肿瘤生长快,转移率高.手术切除率(73.2%)低,预后差,5年生存率低.早期诊断和尽早根治切除是关键问题.     

青年人非小细胞肺癌临床病理特征及预后分析

目的:探讨青年非小细胞肺癌（non-small cell lung cancer,NSCLC）患者的临床病理特征及预后。方法:回顾性分析2000年1月-2011年1月收治、行手术治疗的244例非小细胞肺癌患者的临床病理特征、治疗及预后情况,以40岁为界限,分为青年组（年龄≤40岁）和非青年组（年龄＞40岁）。结果:青年组中女性患者比例高达43.5%,明显高于非青年组13.1%（P<0.001）;而吸烟患者所占比例在两组中分别为54.3%和61.1%,差异无显著性（P>0.05）;青年组的误诊率达56.5%,而非青年组只有22.2%,差异显著（P<0.001）;与非青年组相比,青年组NSCLC更常见于周围型（63% vs 48%,P<0.001）,病理类型多为腺癌（58.7% vs 39.4%,P<0.05）,组织学分级更差（P<0.001）,分期更晚（P<0.05）;而在手术治疗方式上,青年组实施根治性手术比例为71.7%,低于非青年组80.8%,但两组间比较差异不显著（P>0.05）;青年组1、3、5年生存率分别为74%、21.7%和10.8%,与非青年组（75.3%、25.3%和12.1%）比较,差异无显著性（P>0.05）。结论:青年NSCLC患者中女性所占比例较高,误诊率高,周围型腺癌比例高,恶性程度较高,但因其体质好,耐受性好,使其在治疗及预后方面接近或相似于中老年NSCLC患者。     

老年人肺癌的临床特点—附60例临床分析

目的：研究老年人肺癌的临床特点。方法：对６０例老年人肺癌的临床表现、组织学类型、转移情况等进行分析，并与同期青年人肺癌进行对比。结果：老年人肺癌的特点是男性多见、周围型肺癌多见、病理类型以鳞癌居多而小细胞癌较少；吸烟时间长、吸烟量大与肺癌发生相关；临床表现以咳嗽、气短为主要症状，误诊率较高。结论：提高对老年人肺癌临床特点的认识，可减少误诊，改善预后。     

老年人肺癌的临床特点一附60例临床分析

目的：研究老年人肺癌的临床特点。方法：对60例老年人肺癌的临底表现、组织学类型、转移情况等进行分析，并与同期青年人肺癌进行对比。结果：老年人肺癌的特点是男性多见、周围型肺癌多见、病理类型以鳞癌居多而小细胞癌较少；吸烟时间长、吸烟量大与肺癌发生相关；临床表现以咳嗽、气短为主要症状，误诊率较高。结论：提高对老年人肺癌临床特点的认识，可减少误诊，改善预后。     

青年肺癌50例误诊分析

青年肺癌以小细胞未化分癌占多数，近年来，发病率逐渐增加，误诊率７３．５％，误诊为肺结核，肺炎、炎性假瘤等常见病，误诊原因主要为：对青年肺癌的警惕性差；常于常见病的诊断，病史询问不详细；忽视了肺外表面；缺乏综合分析，过份依赖Ｘ线检查；胸液定性错误。     

40岁以下青年人肺癌的临床病理特征和预后

目的　探讨 <4 0岁青年人肺癌的临床病理特征及预后 ,并与≥ 4 0岁的中老年人肺癌进行比较。方法　对 12 9例青年人肺癌 (青年组 )以及随机选择的 14 0例中老年人肺癌 (中老年组 )进行回顾性分析 ,比较两组临床病理特征和生存期。结果　青年组与中老年组相比 ,青年组女性患者比例高 (P =0 .0 37) ,平均症状持续时间长 (4 .7个月 ,P <0 .0 0 1) ,误诊率高 (6 5 .1% ,P <0 .0 0 1) ,平均误诊时间长 (5 .6个月 ,P <0 .0 0 1) ,以腺癌为主要病理类型 (5 4 .3% ,P <0 .0 0 1) ,癌细胞分化差 (6 9.5 % ,P <0 .0 0 1) ,诊断时晚期多 (74 .4 % ,P <0 .0 0 1) ,接受综合治疗的比例高 (94 .6 % ,P <0 .0 0 1) ,因远处转移而致治疗失败者的比例高 (6 4 .7% ,P =0 .0 2 )。两组总的中位生存期和 5年生存率差异无显著性 (P =0 .2 889) ,但Ⅰ期和Ⅱ期中 ,青年组中位生存期及 5年生存率优于中老年组 (P =0 .0 4 95 )。两组肿瘤家族史及吸烟史差异无显著性。结论　青年人肺癌的临床病理特征明显不同于中老年人肺癌 ,但生存期相似。将青年人肺癌定义为“青年型肺癌”有临床实际意义。     

469例经支气管镜检查确诊40岁以下肺癌患者的临床分析

背景与目的近年来,青年肺癌在临床上已不少见,发病率呈逐年上升趋势,临床上易误诊,预后较差。现将我科诊治的469例40岁以下肺癌患者支气管镜及临床特点回顾性分析如下,探讨40岁以下肺癌患者的肿瘤病理分型与性别、生长部位等的关系。方法对经支气管镜检查取材确诊的469例40岁以下肺癌进行回顾性分析。结果469例40岁以下患者肺癌患者中,男性332例,女性137例,男女性别比为2.42:1,病理分型,鳞状细胞癌155例(33.0%),其次是腺癌122例(26.0%),小细胞癌96例(20.5%),男性鳞癌的比例40.7%,明显高于女性14.6%,腺癌比例19.0%明显低于女性43.1%,男性和女性的肿瘤病理类型分布构成有显著差异(P<0.05)。病变部位以双上叶居多,右侧多于左侧。镜下改变新生物及黏膜浸润等直接征象占81.4%。结论40岁以下肺癌患者中,男性以鳞癌为主,女性以腺癌居多。青年人肺癌易漏诊和误诊,支气管镜检查是其诊断的重要手段,应该提高对青年肺癌的警惕和认识,及早进行支气管镜检查。     

Clinicopathological analysis of endometrial carcinoma in young women

Endometrial carcinoma found in patients younger than 50 years of age were analyzed clinicopathologically in comparison with those of other age groups. The results were 1) Out of 150 patients with endometrial carcinoma, 44 (29.3%) were diagnosed in those younger than 50 years of age and 17(11.3%) were under the age of 40. The average age of endometrial cancer was 53.6 years and that of atypical endometrial hyperplasia was 49.2. 2) The majority of these patients (93.4%) had ever complained of vaginal bleeding, whereas those younger than 40 years of age had in 82.4%. 3) History of irregular menstrual cycle was only observed in 25.6% of the patients with the age 50 or older, whereas it was complained of in 61.5% of those among forties and in 56.3% of those younger than 40. 4) Nulliparity was found in 19.8% among 50 and older, whereas 70.4% and 64.7% were seen respectively in those among forties and younger than 40. 5) Hypertension was found more frequently in older patients, but diabetes mellitus and obesity did not correlate with age. 6) Seventy cases (46.7%) has history of receiving screening for cervical cancer without detecting endometrial cancer. 7) Well differentiated adenocarcinoma (G1) and adenoacanthoma was observed frequently in younger age group. Endometrial hyperplasia was often combined with cancer in young women. Having the data above mentioned, importance of screening for endometrial cancer in younger women is discussed.     

Ovarian cancer in younger vs older women: a population-based analysis

To compare the clinico-pathologic prognostic factors and survival of younger vs older women diagnosed with epithelial ovarian cancer. Demographic, clinico-pathologic, treatment, and surgery information were obtained from patients with ovarian cancer from the Surveillance, Epidemiology, and End Results Program from 1988 to 2001 and analysed using Kaplan-Meier estimates. Of 28 165 patients, 400 were <30 years (very young), 11 601 were 30-60 (young), and 16 164 were >60 (older) years of age. Of the very young, young, and older patients, 261 (65.3%), 4664 (40.2%), and 3643 (22.5%) had stage I-II disease, respectively (P<0.001). Across all stages, very young women had a significant survival advantage over the young and older groups with 5-year disease-specific survival estimates at 78.8% vs 58.8 and 35.3%, respectively (P<0.001). This survival difference between the age groups persists even after adjusting for race, stage, grade, and surgical treatment. Reproductive age (16-40 years) women with stage I-II epithelial ovarian cancer who received uterine-sparing procedures had similar survivals compared to those who underwent standard surgery (93.3% vs 91.5%, P=0.26). Younger women with epithelial ovarian cancer have a survival advantage compared to older patients.     

小于30岁低龄肺癌患者的临床分析

背景与目的青年肺癌患者肿瘤恶性程度高,侵袭性强,预后差,已成为多数共识。既往对青年肺癌患者的研究多以40岁或45岁为界,而<30岁的低龄肺癌患者临床资料少见报道。本文回顾分析了解放军总医院从1993年至今17年来诊疗过的<30岁的低龄肺癌患者的病史、分期、治疗及病理特点,为这一年龄段肺癌患者的诊疗提供参考。方法检索解放军总医院收治的1993年以来所有<30岁的肺癌患者,共计53例。其中非小细胞癌患者34例,小细胞癌患者19例。男女比例1.5:1。非小细胞肺癌患者中,腺癌27例,鳞癌6例,腺鳞癌1例,无大细胞癌患者。其中12例接受手术治疗,38例化放疗,3例放弃治疗。结果全组无住院死亡病例,12例手术患者中,手术根治性切除8例,姑息性切除4例。结论低龄肺癌患者腺癌,小细胞癌比例大,多数出现症状就诊时处于晚期,预后差。改善预后应重视常规体检,早期诊断。     

青年原发性支气管肺癌的临床特点分析

目的探讨青年原发性支气管肺癌的临床及病理特点。方法对我院2007年1月-2008年12E经病理学证实的40岁以下217例肺癌患者的资料进行回顾性分析。结果青年人肺癌男女比例为1．47：1;咳嗽、胸痛、血痰最为常见,咳嗽占67.3％;腺癌为42．4％;TNM分期以ⅢB、Ⅳ期为主,达70．5％。结论青年人肺癌以腺癌为主,其次为鳞癌和小细胞癌;确诊时多为晚期,预后差。重视青年患者的肺部表现,及时施行必要的检查,有助于肺癌的早期诊断和治疗。     

低龄肺癌的特点与误诊分析（附47例报告）

目的:探讨低龄肺癌的特点,分析误诊原因,总结早期诊断经验.方法:对误诊的47例低龄肺癌进行回顾性统计.结果:低龄肺癌发病有中年化倾向,发生率为6.35%;误诊率为87.04%;确诊时间在3个月以上者有40.43%;病理分型以腺癌和小细胞癌为主,两者构成比分别为42.53%和23.40%;TMN分期;中、晚期肺癌达93.62%;住院死亡率27.66%,确诊后1年内死亡者占有效随访的86.36%.结论:(1)低龄肺癌以误诊率高、恶性程度高、进展快、转移率高、手术和切除率低、可手术率低、预后差等为主要特点.(2)普遍误诊原因有:对低龄肺癌警惕性不高;鉴别诊断困难.(3)应提高对低龄肺癌的认识,提倡早诊断、早治疗.     

宣威地区与非宣威地区肺癌患者临床流行病学特征及病理类型特点分析

目的:分析宣威地区与非宣威地区的肺癌临床流行病学与病理特征。方法:以云南省肿瘤医院（昆明医科大学第三附属医院）2015年3月至2015年5月手术治疗的肺癌患者为研究对象,共295例,收集患者相关信息。将其分为宣威地区、非宣威地区进行统计。对患者的临床资料进行回顾性分析,包含病理类型、年龄、性别、吸烟史等。结果:宣威地区、非宣威地区肺癌患者男女比例为1.19∶1和1.69∶1。宣威地区患者平均年龄为［53.41±8.74(34~85)］岁,中位年龄53岁。非宣威地区肺癌患者平均年龄为［58.68±8.63(38~78)］岁,中位年龄59岁。宣威地区肺癌高发年龄为40~59岁段。宣威地区I期肺癌患者占比、T1期肺癌患者占比、N0期肺癌患者占比均高于非宣威地区。宣威地区男性腺癌鳞癌比远高于非宣威地区,差异有显著统计学意义。结论:宣威地区女性肺癌发病率更高,发病年龄更趋年轻化,腺癌比例高,吸烟与宣威地区男性腺癌高发关系不密切。     

Gender difference in human papillomarvirus infection for non-small cell lung cancer in Taiwan

Our previous reports have indicated that high risk human papillomarvirus (HPV) 16/18 were much more frequently detected in lung tumors of female patients as compared to that of male patients and HPV 16/18 in lung tumors were evolutionally correlated with those in blood circulation. In the other hand, it is well known that HPV 6/11 are frequently associated with upper aerodigestive and respiratory diseases. HPV 6/11 DNA were detected in lung tumors by nested PCR and in situ hybridization to investigate if any difference in prevalent types of HPV exists between genders. Our data showed that HPV 6 infection was detected in 28.4% (40 of 141) lung tumors, which was significantly higher than that in non-cancer controls (1.7%, 1 of 60; P < 0.0001), however, such high prevalence was not observed for HPV 11. Among studied clinico-pathological parameters, HPV 6 infection was significantly related with gender (P = 0.002) and smoking status (P = 0.014). After being stratified by gender and smoking status, HPV 6 infection rate in lung tumors of non-smoking male patients was much higher than that in non-smoking female patients (33.3% versus 11.1%; P = 0.023), but no difference between smoking and non-smoking male patients (38.1% versus 33.3%). With adjustments for age, tumor type, and tumor stage, smoking male lung cancer patients had a much higher OR value (OR, 7.35; 95%CI, 2.11-25.58) for HPV 6 infection compared with 3.93 (95% CI, 1.17-13.12) of non-smoking male patients. Moreover, a higher prevalence of HPV 6 was detected in lung tumors of smoking male patients with early tumor stage than those with advanced stages (P = 0.008), but not in non-smoking male and female patients. A higher prevalence of HPV 6 in male lung cancer patients, as compared with female lung cancer patients, indicating not only different HPV infection routes for different genders, but also that HPV 6 infections may act as a prospective early risk marker of lung cancer for smoking male patients in Taiwan.     

Comparison between young and old patients with bronchogenic carcinoma

The aim of this study was to compare the clinical characteristics, histological type, stage at diagnosis, treatment and survival of young (< or = 45 years) and older patients with bronchogenic carcinoma. The study was designed as a retrospective review of all lung cancer patients referred to the Kuwait Cancer Control Center over a 10-year period from 1985 to 1994. The study comprised 590 patients with primary bronchogenic carcinoma, of whom 72 (12%) were < or = 45 years of age at the time of diagnosis. Median (range) duration of symptoms, percentage of smokers and male to female ratios for the younger and older patients were 8 (2-48) weeks vs. 8 (1-52) weeks (p = 0.9), 74% vs. 83% (p = 0.06) and 5.5 vs. 5.3, respectively. The majority of patients had advanced stage disease at presentation; 91% of the younger patients had stage III or IV compared with 88% of the older patients (p = 0.1). The histological types for the younger and older patients were 32% vs. 20% for adenocarcinoma (p = 0.01) and 33% vs. 45% for squamous cell carcinoma (p = 0.1). There were more patients in the younger group who had surgery (21% vs. 7.5%) than in the older group (p = 0.001). Follow-up data were available for 177 patients out of 190 Kuwaiti national patients (93%). The median (range) survival rates for young and old patients were 8 (3-62) months and 7 (1-174) months, respectively (p = 0.09). Only 6 patients survived for more than 5 years, one (7.6%) from the younger group and 5 (3%) from the older group. Our study shows a relatively high percentage of young patients in our population of lung cancer patients. Apart from the higher incidence of adenocarcinoma in the young group and the fact that these patients had more surgery than the older group, there were no other significant differences between the two groups.