Department of Medical Oncology, the Third Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150081, China.
Chin Med J (Engl). 2012 Jan;125(1):72-80.
Risk factors that contribute to younger patients with lung cancer are still relatively unknown. The aim of this study was to compare the clinical characteristics, histological types, stages at diagnosis, treatment modalities and survival rates between young and old patients with lung cancer.
The study was designed as a retrospective review of all lung cancer patients admitted to the Third Affiliated Hospital of Harbin Medical University from 1998 to 2008. Survival analyses using univariate and multivariate approaches were performed to compare the survival rates between different age groups and to discover potential prognostic factors.
This research included 3320 patients with primary lung cancer, of whom 626 (18.8%) were 45 years old or younger at the time of diagnosis. The percentage of smokers and the male to female ratios between the young and old patient groups were 51.27% vs. 70.6% (P < 0.001) and 1.99 vs. 2.13 (P = 0.4801), respectively. The young patient group had a higher incidence of adenocarcinoma and fewer surgeries. The 1-year, 3-year and 5-year survival rates in the young patient group were generally lower than those of the old patient group, with significant differences (P = 0.0232). The clinical stage of the tumor was a prognostic factor for both non-small cell lung cancer patients (P < 0.0001) and small cell lung cancer patients (P = 0.0002). Symptoms, diagnostic method, histology, smoking, treatment modality and body mass index were shown to have significant relationships with the survival of lung cancer patients (P < 0.05).
Patients with lung cancer who are younger than 45 years old might have a significantly poorer prognosis than that of older patients. Symptoms, diagnosis method, histology, smoking, treatment modality and body mass index can be independent prognostic factors for lung cancer.
导致肺癌患者年轻化的风险因素仍相对未知。本研究旨在比较年轻和老年肺癌患者的临床特征、组织学类型、诊断时的分期、治疗方式和生存率。
本研究设计为回顾性分析哈尔滨医科大学附属第三医院 1998 年至 2008 年收治的所有肺癌患者。采用单因素和多因素分析方法比较不同年龄组的生存率,并发现潜在的预后因素。
本研究共纳入 3320 例原发性肺癌患者,其中 626 例(18.8%)在诊断时年龄为 45 岁或以下。年轻组和老年组的吸烟者比例和男女比例分别为 51.27%比 70.6%(P<0.001)和 1.99 比 2.13(P=0.4801)。年轻组腺癌的发病率较高,手术较少。年轻组患者的 1 年、3 年和 5 年生存率普遍低于老年组,差异有统计学意义(P=0.0232)。肿瘤的临床分期是非小细胞肺癌患者(P<0.0001)和小细胞肺癌患者(P=0.0002)的预后因素。症状、诊断方法、组织学、吸烟、治疗方式和体重指数与肺癌患者的生存显著相关(P<0.05)。
年龄小于 45 岁的肺癌患者预后可能明显差于老年患者。症状、诊断方法、组织学、吸烟、治疗方式和体重指数可能是肺癌的独立预后因素。