气道阻塞与肺癌危险性的相关性研究

摘要

Objective To analyze the relationship between airway obstruction and the risk of lung cancer.Methods The analysis was based on the data collected in the hospital of Soochow University from September 2012 to August 2015.Three hundred and ninety-three cases of newly diagnosed patients with lung cancer selected as lung cancer group and four hundred patients without any cancer selected as control group were compared for case-control study.Results The patients with chronic obstructive pulmonary disease (COPD) had an increased risk of lung cancer(OR=2.18),the same result was obtained when the smoking factor was controlled(OR=2.18).When forced expiratory volume in one second (FEV1) was lower than 60%,the OR value of lung cancer happening was 2.41.When the smoking factor was controlled,the OR value of lung cancer happening was 2.41.When FEV1/FVC was lower than 50%,the OR value of lung cancer happening was 2.87.After the smoking factor was controlled,the OR value of lung cancer happening was 2.87 and 2.88 when FEV1 was lower than 60% and FEV1/FVC was lower than 50%.The MMEF,FEF50% and FEF75% of lung cancer group were significantly different with that of the control group (P<0.05).Conclusion The patients with a history of COPD have a higher risk of lung cancer.The airway obstruction is another risk of lung cancer except smoking and the risk of lung cancer could increase with the degree of airway obstruction.%目的 探讨气道阻塞与肺癌危险性之间的关系.方法 收集2012年9月至2015年8月苏州大学附属第二医院首诊为肺癌的393例患者为肺癌组及400例无任何部位肿瘤的患者作为对照组进行病例对照研究.收集患者一般资料、吸烟史、病理类型、病灶部位(中央型和周围型)、分期.比较两组患者第1秒用力呼气容积占用力肺活量百分比(FEV1/FVC)、第1秒用力呼气容积占预计值百分比(FEV1%预计值)、最大呼气中期流量(MMEF)和25%、50%用力肺活量时的呼吸流速(FEF25%和FEF50%)占预计值百分比.结果 合并慢性阻塞性肺疾病(COPD)肺癌发生的OR值为2.18.控制吸烟因素影响后,合并COPD肺癌发生的OR值为2.09.FEV1%<60时肺癌发生的OR值为2.41,FEV1/FVC<50%时肺癌发生的OR值为2.87;控制吸烟因素影响后,FEV1%<60时肺癌发生的OR值为2.41,FEV1/FVC<50%时肺癌发生的OR值为2.88.肺癌组MMEF、FEF50%、FEF75%与对照组比较,差异有统计学意义(P<0.05).结论 合并COPD患者,肺癌发生的危险性明显升高.气道阻塞是除吸烟以外另一个影响肺癌发生的危险因素,随着气道阻塞程度的加重,肺癌发生的危险性增加.