青年人非小细胞肺癌临床病理特征及预后分析

摘要

目的：探讨青年非小细胞肺癌（ non-small cell lung cancer，NSCLC）患者的临床病理特征及预后。方法：回顾性分析2000年1月-2011年1月收治、行手术治疗的244例非小细胞肺癌患者的临床病理特征、治疗及预后情况，以40岁为界限，分为青年组（年龄≤40岁）和非青年组（年龄＞40岁）。结果：青年组中女性患者比例高达43.5%，明显高于非青年组13.1%（P＜0.001）；而吸烟患者所占比例在两组中分别为54.3%和61.1%，差异无显著性（ P＞0.05）；青年组的误诊率达56.5%，而非青年组只有22.2%，差异显著（ P＜0.001）；与非青年组相比，青年组 NSCLC 更常见于周围型（63% vs 48%，P＜0.001），病理类型多为腺癌（58.7% vs 39.4%，P＜0.05），组织学分级更差（P＜0.001），分期更晚（P＜0.05）；而在手术治疗方式上，青年组实施根治性手术比例为71.7%，低于非青年组80.8%，但两组间比较差异不显著（ P＞0.05）；青年组1、3、5年生存率分别为74%、21.7%和10.8%，与非青年组（75.3%、25.3%和12.1%）比较，差异无显著性（ P＞0.05）。结论：青年NSCLC患者中女性所占比例较高，误诊率高，周围型腺癌比例高，恶性程度较高，但因其体质好，耐受性好，使其在治疗及预后方面接近或相似于中老年NSCLC患者。%Objective:To exPlore the clinicoPathological features and Prognosis of young PeoPle with non-small cell lung cancer. Methods:The data of the clinicoPathological features and Prognosis of 244 cases treated by oPeration from January 2000 to January 2011 were analyzed retrosPectively. The Patients were divided into two grouPs by age at onset:youth grouP(≤40 years old)and non-youth grouP( >40 years old). Results:The ratio of female Patients was 43. 5% in the youth grouP,significantly higher than 13. 1% in the non-youth grouP(P<0. 001). There were no significant difference in the ratios of smokers in the two grouPs(54. 3% vs 61. 1%,P>0. 05). The misdiagnosis rate was 56. 5% in the youth grouP,significantly higher than 22. 2% in the non-youth grouP(P<0. 001). Com-Pared with the non-youth grouP,there were more PeriPheral NSCLC(63% vs 48%,P<0. 001),more adenocarcino-ma(58. 7% vs 39. 4%,P<0. 05),worse histological grade(P<0. 001)and later stage(P<0. 05)in the youth grouP. The ratio of radical surgery in the youth grouP was lower than that in the non - youth grouP(71. 7% vs 80. 8%),but this difference was not significant(P>0. 05). The ratios of 1-year survival,3-year survival and 5-year survival in the youth grouP were 74%,21. 7% and 10. 8%,lower than that in the non-youth grouP,which were 75. 3%,25. 3% and 12. 1%,difference was not significant( P >0. 05 ). Conclusion:In the young Patients with NSCLC,the ratios of female,misdiagnosis and PeriPheral adenocarcinoma and the degree of malignancy were higher. However,because of good Physique and tolerance,the treatment and Prognosis of the young Patients with NSCLC were closed to or similar to the elderly Patients with NSCLC.