青年肺癌与老年肺癌临床分析

回顾性分析 1992～ 2 0 0 1年收治的≤ 40岁肺癌 40例及近 5年收治的≥ 6 0岁肺癌 90例临床资料。结果青年肺癌与老年肺癌分别占同期肺癌的 10 6 %及 6 9 2 % ,临床表现均以咳嗽、胸痛、咯血、胸闷为多见 ,青年肺癌以腺癌居多、未分化癌次之 ,而老年肺癌则以鳞癌为多 ,腺癌次之 ,且青年组首发症状至就诊时间短、较早发生胸膜及全身转移、预后差 ,此外老年肺癌的发生还与吸烟有关。     

青年肺癌与老年肺癌临床分析

回顾性分析1992-2001年收治的≤40岁肺癌40例及近5年收治的≥60岁肺癌90例临床资料。结果青年肺癌与老年肺癌分别占同期肺癌的10.6%及69.2%，临床表现均以咳嗽，胸痛，咯血、胸闷为多见，青年肺癌以腺癌居多，未分化癌次之，而老年肺癌则以鳞癌为多，腺癌次之，且青年组首发症状至就诊时间短，较早发生胸膜及全身转移，预后差，此外老年肺癌的发生还与吸烟有关。     

老年人肺癌诊治特点(附113例临床分析)

目的　探讨老年人肺癌临床诊治特点。方法　对 113例老年肺癌进行回顾性临床分析。结果　老年人肺癌为同期肺癌的 2 3.6 % (12 8/ 5 42 )。临床表现主要有咳嗽、咳痰、咯血 ,听诊局部呼吸音降低和 (或 )湿罗音。约2 0 %病人无症状而在体检时发现。误诊漏诊率 13.3%。早期手术治疗预后较好。术后 5年生存 5例 (4 .4% )。结论　提高早期确诊率 ,及时采取有效治疗对老年肺癌的预后有重要作用     

青年肺癌35例临床特点分析

我院 1990年 1月 -2 0 0 2年 8月经病理或 和细胞学检查证实的青年 (≤ 40岁 )肺部恶性肿瘤患者 35例 ,作者就其临床特点进行分析 ,报告如下。1　临床资料1.1　病例来源本组 35例中 ,男性 2 5例 ,女性 10例 ;平均年龄 34 5岁 ( 2 0～ 40岁 )。所有病例均经纤维支气管镜活检 ,淋巴结活检或反复抽胸腔积液找到肺癌细胞。 35例中小细胞未分化癌 16例 ,占 45 7% ;鳞癌 12例 ,占 34 2 % ;腺癌 6例 ,占 17 1% ;大细胞未分化癌 1例 ,占 2 9%。1.2　吸烟史35例中 ,有吸烟史者 2 0例 ,其中女性 3例。吸烟时限 10年以上且吸烟指数 (平均每日吸烟…     

青年肺癌19例临床分析

近年来,我国肺癌的发病率呈明显上升的趋势,而青年肺癌病例增加尤为明显。我院1988～2003年共收治308例,其中青年肺癌(<40岁)19例,结果报道如下。1临床资料1.1一般资料1988年3月1日～2003年12月30日收治的308例患者中,40岁以下者19例,占6.17%,全部经活检、纤支镜或术后病理检查确诊。男11例,女8例。年龄25～40岁,平均年龄35.6岁,中位年龄36.5岁。以刺激性干咳为首发症状者12例,占63.2%;痰中带血者8例,占42.1%;胸痛、发热者各5例,分别占26.3%。2例以左锁骨上结节为首发症状。右侧中心型肺癌5例,周围型肺癌6例,其中上叶3例,中叶1例,下叶2例;左…     

老年人肺癌320例分析

目的 :研究老年人肺癌的临床特点、误诊原因及治疗方法。方法 :回顾性分析 1980～ 1999年收治的≥ 60岁肺癌 32 0例临床资料。结果 :老年人肺癌占同期肺癌的 38.0 % ,男女之比为 3∶1。临床表现以咳嗽 ( 82 .8% )、咯血 ( 4 1.0 % )、胸痛 ( 2 6.9% )、胸闷 ( 36.6% )常见 ,全身症状 75.5%和肺外表现4 3 4 %亦多见。误诊原因主要是肺外症状多、伴随基础病多、辅助检查无特异性。老年人肺癌总的 5年生存率 15.6% ,综合治疗、单纯手术、放疗、化疗及其他治疗 5年生存率分别为 30 .0 %、2 0 .0 %、5.6%、0、0。结论 :老年人肺癌发病率高 ,女性发病率上升应重视 ,掌握其临床特点 ,结合合理的辅助检查可望减少误诊。治疗方法以手术为主的综合治疗为首选。     

青年肺癌的临床特点及误诊原因分析--附32例报告

对32例青年肺癌临床表现及误诊原因进行分析,发现青年肺癌误诊率高,为87.5%(28/32).误诊疾病的频次依次为肺结核、肺炎、胸膜炎等.误诊的主要原因是首诊医生对青年肺癌的临床特点缺乏充分的认识.     

青年和老年131例肺癌临床分析

青年和老年１３１例肺癌临床分析张伯敏，谭萍德州市肿瘤医院（山东省德州市２５３００４）肺癌是常见的恶性肿瘤，好发年龄为４０～６０岁，近年来青年、老年患者逐渐多见。我院自１９９０～１９９４年５月间共收治原发性肺癌２９５例。本文只对４０岁以下４８例（１６．...     

原发性中叶肺癌外科治疗45例

 【摘要】　目的　分析原发性中叶肺癌的临床诊断和治疗效果，为临床诊治提供依据。方法　回顾性分析该院2002年 1 月至2007年1月外科手术治疗的45例原发性中叶肺癌的临床资料。45例中男性31例，女性 14例。年龄37～75岁，平均56 岁。手术方式：单纯中叶切除12 例（26.7 ％），中上叶切除10例（22.2 ％），中下叶切除14例（31.1 ％），右全肺切除 5例（11.1 ％），开胸探查2例（4.44 ％），姑息性切除或肿物楔行切除2 例（4.44 ％）。结果　45例中因并发肺部感染、呼吸衰竭死亡1例（2.2 ％）；并发心律失常 15 例（33.3 ％），其中心房颤动8例，室性期前收缩5例，室上性心动过速 2 例；并发乳糜胸 1 例，经保守治疗而痊愈出院。1、3、5年生存率分别为82.1 %、64.3 %、32.1 %。结论　原发性中叶肺癌的治疗仍以外科规范化肺叶切除为主。单纯中叶切除难度较大，故常需行双肺叶切除或全肺切除，而中叶袖状切除由于并发症多应慎用，对原发性中叶肺癌应避免行肿物楔行切除，以减少局部复发。     

Ⅲ期以上肺癌外科治疗45例临床分析

近年来 ,随着外科技术的提高 ,基层医院也大量开展了晚期肺癌的外科治疗 ,分析我院 45例Ⅲ期以上肺癌手术切除的临床资料 ,就有关问题作初步探讨。1　临床资料1 1　一般资料1995年 2月 -2 0 0 1年 12月 ,我们对 45例Ⅲ期以上肺癌患者施行外科手术 ,其中男 2 7例 ,女 18例 ;年龄 2 4～ 72岁 ,平均5 2 4岁 ;中央型肺癌 17例 ,周围型肺癌 2 8例。病理类型 :鳞癌2 2例 ,腺癌 17例 ,小细胞癌 4例 ,腺鳞癌 2例。按pTNM分期 :ⅢA期 2 5例 (T2 N2 M0 9例、T3N0 M0 10例、T3N1 M0 4例、T3N2 M0 2例 ) ,ⅢB期 18例 (T4 N1 M0 11例、T4 N2 M…     

Clinical analysis of 45 patients with thymic carcinoma

OBJECTIVE To retrospectively evaluate the prognostic factors for advanced thymic carcinoma. METHODS The data from 45 patients with advanced thymic carcinoma were retrospectively analyzed according to Masaoka stage criteria. There were 29 Stage Ⅲ patients and 16 Stage Ⅳ patients （13 Stage ⅣA patients and 3 Stage ⅣB patients）. According to the World Heath Organization Histological Criteria （2004）, 25 cases were identified as low-grade and 20 cases were identified as high-grade. All diagnoses were confirmed by biopsy. Five patients underwent gross total resection, 21 patients underwent subtotal resection and 19 patients underwent biopsy alone. Forty-two patients received radiotherapy with a median dose of 60 Gy, and 37 patients underwent conventional radiotherapy, including local irradiation and expanded irradiation. Local irradiation volume covered the primary tumor bed and approximately 1-2 cm^2 surrounding the tumor （according to preoperative imaging）. Expanded irradiation volume covered the full mediastinal and pericardium areas （with or without prophylactic irradiation in the supraclavicular area）. Five cases received stereotactic radiotherapy. Thirty-one patients were also treated with chemotherapeutics, including Cisplatin, VP-16, Endoxan, 5-FU and taxol. RESULTS The median follow-up period was 59 months. The overall 3-year survival rate was 57.8%, and the median survival was 45 months. Univariate statistical analysis showed that the histological subtype and Masaoka stage were prognostic factors. The 3-year survival rate was 61.9% in patients treated with gross total resection and 55.0% in those who underwent biopsy only. The 3-year survival rate was 59.5% in patients treated with conventional radiotherapy and 80% in those treated with stereotactic radiotherapy. The 3-year survival rate was 64.5% in patients treated with simultaneous chemotherapy and 42.9% in patients treated without simultaneous chemotherapy （P 〉 0.05）. Chemotherapy in combination with radiation treatment and surgery achieved better outcomes for Stage Ⅳ patients than radiation treatment and surgery without chemotherapy （P 〈 0.05）.
CONCLUSION For patients with Stage Ⅲ and Ⅳ thymic carcinoma, complete resection and postoperative radiotherapy or fractionated stereotactic radiotherapy constitute the best treatment solution. Chemotherapy can also be used in combination to improve prognosis. For patients with Stage Ⅳ thymic carcinoma, chemotherapy is necessary.     

484例青年人肺癌临床分析

目的为研究青年人肺癌的临床特点和生存情况。方法回顾性分析484例年龄≤45岁的青年人肺癌患者资料,和同期3 267例非青年人肺癌比较临床特点构成和生存。采用SPSS 10.0软件分析青年人肺癌和非青年人肺癌临床特点和生存的差异。结果 484例青年人肺癌中男性有363例（75.0%）,女性121例（25.0%）。有吸烟史282例（58.3%）,重度吸烟者（≥400年支数）215例（44.4%）。和非青年人肺癌比较,青年人肺癌在性别、吸烟情况、合并慢性支气管炎、病理类型和分期等方面有明显差异,表现为女性、腺癌、小细胞癌及进展期（Ⅲ~Ⅳ期）等因素在青年人肺癌病例中所占比例较非青年人肺癌组高。青年人肺癌和非青年人肺癌在治疗情况和生存情况方面无明显差异。结论青年人肺癌和非青年人肺癌比较在多个方面有其特点,应该开展适合青年人肺癌特点的治疗和研究。     

Clinical characteristics of 45 patients with invasive pulmonary aspergillosis

BACKGROUND:

Invasive aspergillosis (IA) is a common complication in patients with hematologic malignancies. Patients with solid tumors also are at risk for IA because they may develop neutropenia as a result of chemotherapy and radiotherapy. However, studies of IA in patients with solid tumors are rare. In this study, the risk factors and clinical characteristics of pulmonary infection and death mediated by invasive pulmonary aspergillosis (IPA) as complications in patients with lung cancer were determined.

METHODS:

The authors conducted a retrospective analysis of the clinical notes from 45 patients who had IPA.

RESULTS:

Among 1711 patients with lung cancer, 45 patients contracted pulmonary aspergillosis (2.63%). There were 10 cases of proven disease and 35 cases of probable disease. In univariate analysis, the main predisposing factors were clinical stage IV disease (P = .018), chemotherapy during the month preceding infection (P = .033), and corticosteroid use (≥3 days; P = .038). In multivariate analysis, only clinical stage IV disease (P = .018) was associated with IPA. Furthermore, the mortality rate among lung cancer patients who had pulmonary aspergillosis was 51.1% (23 of 45 patients). Of the patients who died, corticosteroid therapy (P = .001) and grade 3/4 neutropenia (P = .013) were correlated statistically with pulmonary aspergillosis in patients with lung cancer.

CONCLUSIONS:

In univariate analysis, the risk factors for IPA in lung cancer included chemotherapy and corticosteroid use in the month preceding infection and clinical stage IV disease. However, in multivariate analysis, only clinical stage IV disease was identified as a risk factor for IPA. Cancer 2009. © 2009 American Cancer Society.     

青少年甲状腺癌25例临床分析

目的:分析探讨青少年甲状腺癌的临床特点、诊治及预后。方法:回顾性分析我院1993~2006年间收治的18岁以下青少年甲状腺癌患者25例。结果:乳头状腺癌21例,滤泡状癌2例,乳头滤泡状癌2例。均行手术治疗,患侧腺叶加峡部切除6例,患侧腺叶加峡部切除及对侧大部切除17例,甲状腺全切术2例,单侧功能性颈淋巴结清扫术15例,双侧颈清扫术4例,术后病理示颈淋巴结转移19例。所有患者术后均予甲状腺素治疗。平均随访8年(1~14年),5年生存率92.0%,获10年随访患者10年生存率86.9%。结论:青少年甲状腺癌预后较佳,治疗的关键是正确根据其病理类型和病情选择合适的手术方式。     

青少年甲状腺癌20例临床分析

为总结近年青少年甲状腺癌的临床特点、诊断和治疗方法.回顾性分析烟台毓璜顶医院甲状腺外科1990-2007年收治的≤18岁青少年甲状腺癌患者20例.其中,乳头状腺癌17例,滤泡状癌2例,乳头滤泡状癌1例,均行手术治疗.患侧腺叶加峡部切除2例,患侧腺叶加峡部切除及对侧大部切除18例,单侧功能性颈淋巴结清除术13例,双侧颈部淋巴结清除术2例,术后病理示颈淋巴结转移15例.所有患者术后均予甲状腺素抑制治疗.平均随访8年(1～16年),5年生存率100.0%,荻10年随访患者10年生存率85.7%.初步研究结果提示,青少年甲状腺癌预后良好,正确的诊断和恰当的治疗是取得长期生存的关键.中华肿瘤防治杂志,2010,17(1):73-74     

外科治疗肺孤立性结节45例临床分析

目的:探讨肺孤立性结节的临床特点和治疗方法。方法:回顾性分析我科2003年1月至2009年5月手术治疗45例肺孤立性结节(直径≤3cm)的临床资料,其中开胸肺叶切除术25例,胸腔镜下肺叶切除5例,肺楔形切除术14例,肺肿瘤摘除术1例。结果:术后病理诊断腺癌13例,鳞癌5例,小细胞癌2例,肺泡细胞癌1例,腺样囊性癌1例,转移性癌3例,结核球或肉芽肿8例,炎性假瘤8例,肺曲菌病3例,硬化性血管瘤1例。所有患者均无严重并发症痊愈出院。结论:肺孤立性结节病因复杂,诊断有一定的困难,恶性病变比例较高,尽早手术是明确诊断和提高治愈率的关键。     

CLINICAL ANALYSIS OF 150 PATIENTS WITH PERIAMPULLARY CARCINOMA

ＣＬＩＮＩＣＡＬＡＮＡＬＹＳＩＳＯＦ１５０ＰＡＴＩＥＮＴＳＷＩＴＨＰＥＲＩＡＭＰＵＬＬＡＲＹＣＡＲＣＩＮＯＭＡ￥ＷｕＸｉａｎｇｄｅ；吴祥德；ＳｏｎｇＺｈｅｎｃｈｕａｎ；宋振川；ＧｅｎｇＣｕｉｚｈｉ；耿翠芝；ＬｉＢｉｎｇｈｕｉ；李秉慧（Ｄｅｐａｒｔｍｅ...     

Clinical analysis of 140 patients with periampullary carcinoma

From 1964 to 1984, 140 patients were treated by operation in our hospital with the diagnosis of periampullary carcinoma established by exploration or pathology. 86 patients were male and 54 were female. The age ranged from 29 to 73 years. 126 (90%) of them were over forty, pancreatoduodenectomy was performed in 60 patients. The resection rate was 42.9%. The operation mortality was 11.7%. Pancreatoduodenectomy gave a mean postoperative survival of 22 months. The longest survival was 13 years 10 months, palliative choledochoenterostomy or gastro-enterostomy was done in 66 patients with a mean survival of 5.2 months. 14 patients were given laparotomy only with a mean survival of 4 months. In this paper, the diagnosis of periampullary carcinoma, early postoperative complications of pancreatoduodenectomy and prognosis are discussed.     

45例胶列腺癌放射治疗的临床分析

目的 分析前列腺癌放射治疗的疗效及预后因素。方法 回顾分析本院常规放射治疗前列腺癌45例，41例放射治疗前接受双侧睾丸切除，29例同时服用内分泌治疗药物。采用常规放射治疗技术，5次／周，1.8-2.0Gy/次，肿瘤剂量最低50.4Gy,最高75.9Gy，中位68.3Gy。结果 中位随访28个月（范围1－111个月），随访率91.1%。5年总生态率为76.4%，肿瘤特异生存率为76.5%。1、2、3级急性胃肠道反应发生率分别为53.5%、7.0%、9.3％，1、2级急性泌尿生殖系统反应发生率分别为41.9%、4.7%；1、2级胃肠道晚期反应发生率分别为16.7%、7.1%，1、2、3级泌尿生殖系统晚期反应发生率分别为23.8%、4.8%、2.4%。结论 前列腺癌的放射治疗结果较为满意，治疗的副反应尚能承受。     

48例肺癌性空洞临床分析

 本文采用纤维支气管镜刷检细胞学、活检病理学和/或支气管肺活检(TBLB)确诊肺癌性空洞48例，其中鳞癌34例(70.8%)、腺癌11例(22.9%), 未分化小细胞癌3例(6.3%)。 肺癌性空洞多见于鳞癌和年龄偏大的患者。 本文侧重于该病与肺内其他空洞性病变症状、X线方面的鉴别, 也对肺癌性空洞的形成机理提出了较新的见解。