慢性阻塞性肺疾病与支气管肺癌的临床关系  

Clinical relationship between chronic obstructive pulmonary disease and bronchial carcinoma

作　　者：吴志伟[1] 吴逸明[2] 李智慧[1] 刘红[1] 

机构地区：[1]郑州大学第一附属医院呼吸内科,450052 [2]郑州大学公共卫生学院

出　　处：《中国实用医刊》2014年第10期3-5,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨慢性阻塞性肺疾病（COPD）与支气管肺癌的，临床关系，指导临床早期诊断和治疗COPD合并支气管肺癌。方法回顾性分析2012年1月至2013年6月就诊的72例COPD合并支气管肺癌患者的临床资料，包括年龄、性别、吸烟史、肿瘤史、呼吸疾病家族史、病理分型及分期、临床症状和体征及治疗方法等。选出72例单纯肺癌组患者作为对照。采用SPSS17．0统计软件对两组病例的临床资料进行统计学分析。结果①COPD合并肺癌组平均年龄、吸烟史、既往有呼吸疾病家族史、肿瘤家族史均高于单纯肺癌组患者（P〈0．05），两组患者的临床肺癌分期比较差异无统计学意义（P〉0．05）。②COPD合并肺癌组中最常见的临床症状和体征：千咳、声音嘶哑、胸膜腔积液、骨痛与单纯肺癌组比较，差异无统计学意义（P〉0．05），而痰中带血、胸痛、呼吸困难、发热和肺不张与单纯肺癌组比较差异有统计学意义（P〈0．05）。③两组病理类型比较中小细胞癌、腺癌、其他非小细胞癌类型比较差异有统计学意义（P〈0．05），而两组鳞癌病理类型比较差异无统计学意义（P〉0．05）。单纯肺癌组以外科手术治疗为主，COPD合并肺癌组以非手术治疗为主。结论COPD合并支气管肺癌临床症状缺乏特异性，早期确诊率低，COPD患者有长期吸烟史，伴胸痛、血痰、咳嗽性质的改变、胸腔积液、发热、肺不张应警惕合并肺癌可能。Objective To investigate the clinical relationship between patients with chronic ob structive pulmonary disease （COPD）and bronchial carcinoma, in order to provide guidance for early di agnosis and treatment of this comorbidity. Methods The clinical data of 72 cases of COPD combined with bronchial carcinoma who treated in our hospital between January 2012 and June 2013, including age, sex, smoking history, tumor history, past respiratory disease history, symptoms and signs, patholog ical types and pathological stages, treatment of the carcinoma were retrospectively reviewed. The controlgroup included carcinoma. The 72 patients with clinical data only bronchial were analyzed using the SPSS 17.0. Results ①The average age, smoker histories, past histories of respiratory diseases and family histories of cancer in the study group were higher than those of the control group （ P 〈 O. 05 ）. The clinical stages of bronchial carcinoma between the study and control group were no sig nificant difference （P 〉 0.05）. ②The most common clinical symptoms and signs in the study group in cluded cough, hoarseness, pleural effusion, bone pain, which showed no significant difference from the control group（P 〉0.05）. There were statistically significant differences in blood in phlegm, chest pain, dyspnea, fever and pulmonary atelectasis between the study and control groups （ P 〈 0.05 ）. ③There were statistically significant differences in pathological types of small cell carcinoma and adenocarcinoma and non-small cell carcinoma between the study and control groups （ P 〈 0.05 ）. The squamous cell carci- noma pathological type showed no significant difference between them （ P 〉 0.05 ）. The control group was given priority to surgery treatment. The study group was major given non-surgical treatment. Con clusions This comorbidity of COPD-combined bronchial carcinoma lacks specific manifestations and has low early diagnosis rate. COPD patients with long smoking history, chest pain, hemoptysis, th

关 键 词：肺癌 慢性阻塞性肺疾病 回顾性分析 

分 类 号：R734.2[医药卫生—肿瘤]