383例原发性支气管肺癌临床特征的分析研究  

Analysis of the Clinical Feature of 383 Patients with Lung Cancer

作　　者：黎银焕[1] 周燕斌[1] 黄琬玲[1] 蔡兴东[1] 曾庆理[1] 黄丽霞[1] 

机构地区：[1]中山大学附属第一医院呼吸内科,广东省广州市510080

出　　处：《中华全科医学》2011年第7期1006-1007,1105,共3页Chinese Journal of General Practice

基　　金：国家自然科学基金(81071931);教育部回国人员科研启动基金:教外司留(2010-609)

摘　　要：目的了解肺癌的临床特征。方法回顾性分析383例肺癌患者的临床资料。结果肺癌中位发病年龄为59岁。50.1%的患者有吸烟史,其中93.8%的吸烟者为男性。肺癌常见症状为咳嗽、咳痰、体重下降、咯血、胸痛和气促。男性患者血清神经元特异性烯醇化酶(neuron-specific enolase,NSE)和细胞角蛋白19片段(cytokeratin 19 fragment,CYFRA21-1)高于女性;老年患者的血清CYFRA21-1高于非老年患者;吸烟者、中央型肺癌患者的血清NSE和CY-FRA21-1分别高于不吸烟者和周围型肺癌患者;血清癌胚抗原(carcinoembryonic antigen,CEA)、NSE和CYFRA21-1分别在腺癌、小细胞肺癌及鳞癌患者中最高,且肺癌分期越晚,血清CEA、NSE和CYFRA21-1水平越高。肺癌最常发生于两肺上叶,68.6%为周围型肺癌。腺癌和鳞癌是最常见的病理类型。在诊断时,66.0%的患者已属晚期,55.5%的患者有纵隔淋巴结转移,骨骼是肺癌最常见的转移部位。结论肺癌的临床表现具有多样性,大部分患者在诊断时已属晚期,应提高对肺癌的认识,提高早期诊断率。血清肺肿瘤生物学标志物CEA、NSE和CYFRA21-1的联合检测有助于判别肺癌的组织学类型和分期。Objective To understand the clinical feature of lung cancer.Methods The clinical data of 383 lung cancer patients who registered in our hospital between 2007 and 2008 were analyzed retrospectively.Results The median age of lung cancer patients was 59 years old.50.1% of them had a history of smoking,among 93.8% were males.Coughing,expectoration,emaciation,hemoptysis,chest pain and dyspnea were the most common symptoms.The levels of serum neuron-specific enolase（NSE） and cytokeratin 19 fragment（CYFRA21-1） in males were higher than those in females,and the levels of serum CYFRA21-1 in senile were higher than those in non-senile.The levels of serum NSE and CYFRA21-1 in smokers were higher than those in non-smokers,while they were higher in patients with central type than those in patients with peripheral type.The levels of serum NSE in small cell lung cancer patients were higher than those in non-small cell lung cancer patients.The levels of serum carcinoembryonic antigen（CEA） in patients with adenocarcinoma were higher than those in patients with squamous cell carcinoma,while the levels of serum CYFRA21-1 were higher in the latter.The more advanced the disease was,the higher the levels of serum CEA,NSE and CYFRA21-1 were.Carcinoma was most commonly seen in the upper lobes of both sides of the lungs.68.6% of lung cancer belonged to peripheral type.Adenocarcinoma and squamous cell carcinoma were the most common pathological type.66.0% of lung cancer patients were in advanced stage when diagnosed,and 55.5% had metastasis to mediastinal lymph nodes.Bones were the most common sites of metastasis.Conclusion The clinical manifestations were various in lung cancer patients,most of whom were in advanced stage when diagnosis was confirmed.Thus our knowledge to the disease should be enhanced,and early diagnosis for lung cancer should be made.The combined detection of serum CEA,NSE and CYFRA21-1 could be helpful to identify the histological types and stages of lung cancer.

关 键 词：肺癌 临床特征 回顾分析 

分 类 号：R734.2[医药卫生—肿瘤]