上海市某专科医院女性肺癌住院患者生存期分析
Analysis on Clinical Feature and Survival Period of Pulmonary Cancer in Female Patients from One Specialized Hospital in Shanghai
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摘要:
目的 观察上海某专科医院女性肺癌住院患者的临床特征及生存情况。 方法 以2000年1月至2001年12月期间于上海市胸科医院诊治的全部沪籍女性肺癌住院病人作为研究对象,通过病历回顾收集相关资料,并跟踪随访至2009年3月30日。采用描述性分析和寿命表法进行生存分析。 结果 346名病例的平均患病年龄为(59.0& #177;10.4)岁,其中为19例(5.5%)吸烟者;34例(9.8%)为有肿瘤家族史者;腺癌比例最高,为253例(80.8%),腺鳞型、鳞型其次。从病程分期看,65%的病例首次诊断时都已是Ⅲ、Ⅳ期;单纯手术治疗110例、手术联合放化疗5例、手术加化疗76例、单纯化疗92例、放化疗29例及未治疗患者34例。生存分析结果显示,Ⅰa、Ⅰb、Ⅱa、Ⅱb、Ⅲa、Ⅲb、Ⅳ期的中位生存期分别是9.0、9.0、9.0、2.2、1.9、1.2、0.9年(P<0.01),鳞、腺、腺鳞及小细胞型的中位生存期分别是7.0、2.0、1.7、1.2年(P<0.01)。单纯手术、手术联合放化疗、手术加化疗、单纯化疗、放化疗及未治疗患者的中位生存期分别是8.3、6.3、2.9、1.0、0.9、0.7年。 结论 女性肺癌以腺癌为主,不同病理类型、临床分期及不同治疗方式的女性肺癌患者的生存期明显不同。要加强人群定期体检的意识,提高肺癌高危人群定期体检率,早期诊断,提高组织病理学的确诊率,争取手术治疗时机，以改善预后。 Abstract:Objective To describe the clinical features and survival time of pulmonary cancer in female patients diagnosed and treated in a specialized hospital in Shanghai. Methods To excerpt the chart of 346 female lung cancer patients diagnosed and treated in Shanghai Chest Hospital in the period from January 2000 to December 2001, and describe the clinical characteristics and major risk factors. Analysis and correlate the pathologic types and tumor stage with patients survival period through case followup. Results The overall median age was 59 years. 19 cases (5.5%)were smokers and 34 cases (9.8%) had other respiratory diseases. 253 cases (80.8%)were adenocarcinoma, which was the highest proportion over all the other pathologic types. The second and third proportion was adeno-squamous carcinoma and squamous epithelial carcinoma. 65% of the cases were stage Ⅲ and stage IV when diagnosed; 110 cases received surgery, 5 cases received surgery combined with chemo-radiotherapy, 76 cases received surgery combined with chemotherapy, 29 cases received chemoradiotherapy, 34 cases did not receive any special treatment. The median survival times in patients of stage Ⅰa、Ⅰb、Ⅱa、Ⅱb、Ⅲa、Ⅲb、Ⅳ were 9.0、9.0、9.0、2.2、1.9、1.2、0.9 years respectively, The median survival times in patients with squamous carcinoma, adenocarcinoma, adeno-squamous carcinoma, SCLC were 7.0、2.0、1.7、1.2 years respectively, they were statistically significant in difference. The median survival times in patients who received surgery alone, surgery combined with chemoradiotherapy, surgery combined with chemotherapy, chemotherapy alone, chemoradiotherapy, and with out any special treatment were 8.3、6.3、2.9、1.0、0.9、0.7 years, respectively. Conclusion Adenocarcinoma is the most common pathological types in female lung cancer in Shanghai. The pathologic types, tumor stage, and methods of treatments are the main prognostic factors for the overall survival in female lung cancer. It is necessary to strengthen people's awareness of and push forward the periodic physical examination. It is the most reliable means to detect and early diagnosis patient from high risk group, raise the accuracy of histopathological diagnosis, catch time for receiving surgical treatment, extend survival time, and improve the prognosis.
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