老年恶性肿瘤 70 例临床分析

目的总结老年恶性肿瘤特点，分析老年恶性肿瘤患者延误诊断相关因素，探讨制订相应诊断对策。方法对70例60岁以上住院治疗的老年恶性肿瘤患者的临床特征进行回顾性分析。结果70例患者的患病部位涉及呼吸、消化、泌尿、神经等多个系统和器官，其中肺癌患病率最高（34．3％）；患者就诊时间晚，发病至确诊时间平均6．2个月（2天至12个月），临床表现不典型，病理诊断率低（51．4％）；确诊时临床分期多为晚期，Ⅲ～Ⅳ期患者的比例为78．6％；所有患者中前列腺癌肿瘤标志物阳性率最高（100．0％）；院内死亡原因多为感染（69．0％）。结论加强埘老年人的肿瘤筛查，警惕老年患者的不典型症状，合理选用辅助检查，提高早期诊断比例。旦确诊，应进行老年综合评估（comprehensive geriatric assessmeHt，CGA），制订个体化治疗方案，提高患者生存质量。

Clinical analysis of 70 elderly patients with malignant tumors

Objective To summarize the characteristics of aged patients with malignant tumor, and to analyze the related factors of delayed diagnosis, and discuss the corresponding measures for diagnosis. Method The clinical characteristics of 70 inpatients over 60 years with malignant tumor were retrospectively analyzed. Result In the 70 patients, tumor-involved systems included respiratory, digestive, urinary, nervous system and organs, with lung cancer being most popular （ 34. 3%） ; The time when patients come to consult doctors were often late, and the average duration of onset to diagnosis was 6.2 months （2 days to 12 months）, with atypical clinical manifestation, resulting in low pathological diagnosis rate （51.4%）; When diagnosed, most patients were in advanced clinical stage, of which stage III to IV accounted for 78.6% ; Tumor marker positive rate of prostate cancer was the highest in all patients （ 100. 0% ） ; And the lnost common cause for death in hospital was infection （ 69.0% ）. Conclusion Cancer screening for elderly people should he strengthen, and atypical symptoms of elderly patients are vigilant, only with appropriate auxiliary examination can early diagnosis be improved. A comprehensive geriatric assessment （CGA） should be carried out in the wake of diagnosis, and then individualized treatment protocol should follow to improve the quality of life of patients.