非小细胞肺癌病理类型对肺功能的影响

摘要

目的:探讨非小细胞肺癌组织类型与肺功能的关系.方法:对621例肺癌患者用支气管镜和肺CT评价病变位置,根据吸烟指数分为重度、中度和轻度人群.对性别、年龄、病变部位、吸烟指数和肺通气功能测试参数进行分析.结果:肺鳞癌与肺腺癌患者相比吸烟指数明显增高(P＜0.01),且重度吸烟患者比例大,轻度吸烟患者比例小,FVC%、FEV1%、PEF%、FEF50%、FEF75%均有下降趋势.中心型肺癌,肺鳞癌与腺癌患者相比,平均年龄较大,PEF下降明显.周边型肺癌,各项指标均无显著差异.按年龄分层,随着年龄的增大,肺鳞癌与腺癌患者相比FVC% 、FEV1% 、PEF%明显下降(P＜0.05).在不吸烟组与腺癌比鳞癌FVC%、FEF50%和 FEF75%降低.结论:肺鳞癌与腺癌比对肺通气功能损伤大,大于60岁的肺鳞癌患者这种损伤更重.非小细胞肺癌病理类型与肺功能关系密切,肺功能受吸烟、年龄、病变位置等因素的影响.%Objective:To investigate the relationship between pulmonary function and pathological types of non small cell lung cancers ( NSCLC) .Methods : Fiberoptic bronchoscopy and pulmonary CT were used to locate lesions in 621 lung cancer patients, while the patients were divided irto three smoking groups ( mild, middle and severe) according to SI ( smoke index).Furthermore, gender, age, location of lesions.SI and pulmonary ventilation function test parameters were analyzed retrospectively.Results: SI was obviously higher in squamous cell carcinoma patients than that in adenocarcinoma patients ( P ＜ 0.01 ) , and the severe smoking groups higher proportion than the mild groups, while FVC％ , FEV1％ , PEF％ , FEF50％ and FEF75％ all had descending tendencies.Age was older in squamous cell carcinoma patients with central lesions than in adenocarcinoma patients with central lesions, and PEF％ obviously descended in squamous cell carcinuma patients compare with adenocarcinoma patients.But there was no statistical difference in all items in patients with peripheral lung cancer.When the subjects were graded by age, FVC％ , FEV1％ and PEF％ were obviously descend in squamous cell carcinoma patients compare with adenocarcinoma patients(P ＜0.05) as the age growing.FVC％ , FEF50％ and FEF75％ were lower in non - smoking squamous cell carcinoma patients than non - smoking adenocarcinoma patients.Conclusion: The injury of respiratory functions is more prominent in squamous cell carcinoma patients chan in adenocarcinoma, especially in squamous cell caricinoma patients older than 60.The pathological types of NSCLC is closely associated with pulmonary function,and the pulmonary function is influenced by age, location of lesions.