500例肺癌患者首诊症状及其影响因素分析  

Analysis of the First Diagnosis Symptom and Its Influencing Factors in 500 Patients with Lung Cancer

作　　者：张昕 邢镨元 郝学志 李峻岭 Xin ZHANG;Puyuan XING;Xuezhi HAO;Junling LI(National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China)

机构地区：[1]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院,北京100021

出　　处：《中国肺癌杂志》2018年第5期408-412,共5页Chinese Journal of Lung Cancer

摘　　要：背景与目的肺癌的发病率与死亡率不断升高,本研究探讨初诊肺癌患者临床特征,特别是首诊症状对诊断及后续治疗选择的影响。方法回顾性分析自2017年3月-2017年5月我院胸内科门诊就诊的500例肺癌患者,分析其临床特征包括首发症状、分期、生物标志物、病理等对后续治疗选择影响。结果女性(53.3%)、腺癌(74.4%)、吸烟者(58%)多见,大部分患者(98.2%)体力状态评分为0分-1分。生物标志物检测58.2%(n=291),其中表皮生长因子受体(epidermal growth factor receptor,EGFR)突变61.2%(178/291),间变性淋巴瘤激酶(anaplasticlymphoma kinase,ALK)融合基因阳性4.1%(12/291)。不同吸烟状况、是否有症状、病理分型、疾病分期和是否有突变是影响后续治疗的主要因素。结论就诊时有典型症状的患者确诊时间更短,吸烟状况、肺癌相关症状、病理、疾病分期及突变状况是影响后续治疗的主要因素。Background and objective As the morbidity and mortality in lung cancer keep raising, we are here to discuss the effect of clinical features especially the initial symptomon on diagnosis and follow-up treatment of newly diagnosed lung cancer patients. Methods The clinical features of the 500 patients with lung cancer in our hospital from March, 2017 to May, 2017 were analyzed retrospectively, including the initial symptom, stage, biomarkers, pathology, etc. ResultsThere were 266 famle（53.3%）, 372 adenocarcinoma（74.4%）, 285 smokers（58%）, status score of most patients（98.2%） was 0-1. 58.2%（n=291） of all the patients got biomarkers test, of which epidermal growth factor receptor（EGFR） mutations was 61.2%（178/291）, anaplasticlymphoma kinase（ALK） fusion gene positive was 4.1%（12/291）. Smoking status, initial symptom, pathological typing, TNM staging and EGFR mutation were the main factors affecting follow-up treatment. ConclusionPatients with typical symptoms have shorter diagnosis time. Smoking status, lung cancer-related symptoms, pathology, TNM staging and EGFR mutation status are the main factors that affect the follow-up treatment.

关 键 词：肺肿瘤 症状 诊断 治疗 影响因素 

分 类 号：R734.2[医药卫生—肿瘤]