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从1982年至1990年,我院共收治肺癌病人982例,40岁以下青壮年肺癌经手术治疗的80例,占同期全年龄组的8.2%,误诊率为71.2%,病理类型以小细胞癌居多占38.7%.症状以咳嗽、痰血、胸疼为常见。有吸烟史的45例,其中鳞癌和小细胞癌占32例。胸部 X 线片表现有肺部肿块影、肺门肿块、肺不张、癌性空洞等,其中以肺部肿块影较多占43%。肿瘤分布和分期左肺42例,右肺38例,周围型41例,中心型39例.Ⅲa 和Ⅲb 共40例占50%,误诊为肺结核者27例,其它为肺炎、炎性假瘤、肺脓肿空洞等。在切除的64例中(80%),属根治性的42例,姑息性切除22例,全肺切除26例,肺叶切除(包括双肺叶切除或一叶加楔形)38例,术后一、三、五、七年生存率分别为78%、39%、35.1%、21%。在讨论中对发病情况、诊断、胸部 X 线征、病变分布和分期、组织类型、手术等问题都进行了全面和详细的阐述。
From 1982 to 1990, a total of 982 patients with lung cancer were treated in our hospital. 80 patients with lung cancer under the age of 40 were treated by surgery and accounted for 8.2% of the whole age group in the same period. The misdiagnosis rate was 71.2%. The pathological type was small cell carcinoma. Mostly accounted for 38.7%. Symptoms of cough, sputum, chest pain are common. There were 45 cases of smoking history, including 32 cases of squamous cell carcinoma and small cell carcinoma. Chest X-ray showed lung masses, hilar masses, atelectasis, and cancerous cavities, among which lung lumps accounted for 43%. The tumor distribution and staging were 42 cases of left lung, 38 cases of right lung, 41 cases of peripheral type, 39 cases of central type, 40 cases of 5 cases of IIIa and IIIb, and 27 cases of misdiagnosis of pulmonary tuberculosis. Others were pneumonia, inflammatory pseudotumor, Lung abscess empty and so on. Of the 64 cases (80%), 42 cases were radical, 22 cases were palliative resection, 26 cases were pneumonectomy, 38 cases were lobectomy (including double lobar resection or one type of blade plus wedge). The three-, five-, and seven-year survival rates were 78%, 39%, 35.1%, and 21%, respectively. During the discussion, the complications, diagnosis, chest X-ray signs, lesion distribution and staging, tissue type, and surgery were all discussed in detail.