小细胞肺癌的构成及远处转移特征分析

摘要

目的：探讨小细胞肺癌（small cell lung cancer，SCLC）患者的构成特征及远处转移特点。方法回顾性分析2011年1月至2015年12月确诊的SCLC患者的临床资料。结果6830例患者通过组织病理或细胞学确诊为肺癌，其中SCLC 1016例（14.9%），年龄29～87岁，平均（58.47±10.03）岁，中位年龄59岁；＜60岁者占SCLC患者的51.5%，占同期同年龄组诊断肺癌患者的15.7%，且男女之间差异有显著性（17.5% vs 12.6%，P＜0.001）。399例（39.3%）SCLC患者诊断时为广泛期，其中278例（69.7%）存在远处转移，转移部位依次为骨（8.7%）、肝（7.2%）、脑（5.9%）、肺（3.8%）、肾上腺（1.6%）、其他（0.8%，包括胰腺、腹腔等）。男性SCLC发生骨、肝、肾上腺转移的比例较女性多，差异有显著性。结论 SCLC确诊时年龄较西方国家年轻，但远处转移的比例相对较低；肺癌的临床诊断亟待进一步规范，临床决策须重视SCLC早期即可发生远处转移的特点。%ObjectiveTo explore the composition characteristics and distant metastasis features of patients associated with small cell lung cancer (SCLC).MethodThe clinical data of SCLC patients which diagnosed consecutively between January 2011 and December 2015 in Jinqiu Hospital of Liaoning Province were retrospectively analyzed.Result6830 patients diagnosed lung cancer by tissue pathological or cytological specimens, 1016 (14.9%) patients with SCLC were included. The median age was 59 years (range, 29~87 years). The proportion of age under 60 years was 51.5%, accounted for 15.7% of the patients with lung cancer at the same period, and the difference was statistically significant between male and female (17.5% vs 12.6%,P<0.001). 399 (39.3%) patients with SCLC was extensive stage at the time of diagnosis, including 278 (69.7%) patients had distant metastasis, of which 8.7%, 7.2%, 5.8%, 3.8%, 1.6% and 0.8% of patient had bone, liver, brain, lung, adrenal and others (including pancreas and abdominal cavity, etc.). The metastasis sites associated with bone, liver, adrenal gland has statistically significant between male and female.Conclusion The age of SCLC younger than western countries at the time of diagnosis, but the proportion of distant metastases is relatively lower. The diagnosis of lung cancer need more specification, clinical decision need pay more attention to the characteristics of SCLC with early distant metastasis.