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目的探究低龄肺癌患者临床及病理特点,达到提高早期诊疗水平的目标。方法选取2008年1月1日-2014年12月31日首诊于四川大学华西医院的低龄(18~35岁)肺癌患者129例,收集其临床病理资料进行回顾性分析。并与同时期内手术证实为肺部良性占位的32例低龄患者进行临床病理特征对比分析。结果 129例低龄肺癌患者中男57例,女72例;病理类型以腺癌为主(88例),其次为小细胞癌(18例)、鳞癌(13例)及其他类型肺癌(10例);41例(31.8%)患者因顽固性干咳就诊,另40例(31.0%)患者表现为咳嗽伴咳痰;29例(22.5%)患者首诊时有误诊情况。当低龄肺癌患者被初次诊断时,55.8%的患者已为Ⅳ期,伴远处转移。与肺部良性占位癌组相比,肺癌组患者更容易出现干咳(P=0.011)、胸闷气紧(P=0.007)、体质量减轻(P=0.007)的症状;而肺部良性占位组患者更易出现发热(P=0.040);咳嗽咳痰、咯血症状在两组中比较差异无统计学意义(P>0.05)。结论低龄肺癌患者早期症状轻微且不典型,很容易误诊为其他疾病而耽误诊断治疗。
Objective To explore the clinical and pathological features of patients with lung cancer at the younger age, and to achieve the goal of improving the early diagnosis and treatment. Methods From January 1, 2008 to December 31, 2014, 129 first-diagnosed (aged from 18 to 35) lung cancer patients at Huaxi Hospital of Sichuan University were enrolled in this study. The clinical and pathological data were collected for retrospective analysis. The clinical data of 32 patients with benign pulmonary lesions were analyzed retrospectively. Results There were 57 males and 72 females in 129 cases of low-grade lung cancer. The main pathological types were adenocarcinoma (88 cases), followed by small cell carcinoma (18 cases), squamous cell carcinoma (13 cases) and other types of lung cancer ); 41 patients (31.8%) were treated with intractable dry cough and the other 40 patients (31.0%) presented with cough and expectoration; 29 patients (22.5%) had misdiagnosis at the first visit. When younger patients with lung cancer were first diagnosed, 55.8% of patients had stage IV, with distant metastasis. Patients with lung cancer were more likely to develop symptoms of dry cough (P = 0.011), tightness of the chest (P = 0.007) and weight loss (P = 0.007) compared with benign lung cancers Patients in group A were more likely to have fever (P = 0.040). There was no significant difference in cough, expectoration and hemoptysis between the two groups (P> 0.05). Conclusion Early stage lung cancer patients with mild and atypical early symptoms, it is easy to misdiagnosis of other diseases and delay diagnosis and treatment.