Yao Xiao-Jun, Zhnag Hong-Wei, Pu Qiang, Liu Lun-Xu
Sichuan Da Xue Xue Bao Yi Xue Ban. 2014 Mar;45(2):309-15.
To identify changes in patterns of primary bronchogenic carcinoma.
We reviewed clinical data of patients with primary bronchogenic carcinoma, who were identified as permanent residents of Sichuan province and were treated in West China Hospital of Sichuan University in 2000 and 2010. The distributions of gender, age, urban/rural residency, smoking history, occupational exposure and histological types of tumor were compared between the 2000 group and 2010 group.
A total of 2 167 patients (616 in 2000 and 1551 in 2010) met the inclusion criteria. Compared with the 2000 group, the 2010 group had a lower proportion of male patients (male/female sex ratio dropped from 2.78:1 to 2.13:1, P = 0.013), more patients from medium and small sized cities (patients from large city decreased from 42.1% to 32.0%, P < 0.001, and patients from medium and small sized cities decreased from 39.9% to 31.7%, P < 0.001), more patients from rural areas (patients from townships increased from 5.5% to 8.1%, P = 0.041, and patients from villages increased from 12.5% to 28.2%, P < 0.001). No significant difference in age was found in the two cohorts of patients. The proportion of squamous cell carcinoma dropped from 44.8% in 2000 to 28.7% in 2010 (P < 0.001). The proportion of adenocarcinoma increased from 43.0% in 2000 to 53. 1% in 2010 (P < 0.001). The proportion of small cell lung cancer increased from 3.7% in 2000 to 11.9% in 2010 (P < 0.001). The proportion of squamous cell carcinoma in male patients was higher than that of female patients (60.7% vs. 36.6% in 2000; 75.8% vs. 42.9% in 2010). The proportion of adenocarcinoma was higher in female patients than that of male patients (60.7% vs. 36.6% in 2000; 75.8% vs. 42.9% in 2010). The proportion of squamous cell carcinoma was higher in elderly patients (> or = 60) than that of young patients (< 45) (50.5% vs. 33.8% in 2000; 30.2% vs. 15.6% in 2010). The proportion of adenocarcinoma in young patients was higher than of elderly patients (54.9% vs. 36.9% in 2000; 57.1% vs. 51.8% in 2010). Squamous cell carcinoma was predominate in smoking patients (55.6% in 2000; 40.9% in 2010). Adenocarcinoma was predominate in no-smoking patients (58.4% in 2010; 75.7% in 2010) and the patients exposed to risk occupations (46.2% in 2000; 60.2% in 2010).
Over the past decade, the percentages of female patients, adenocarcinoma and small cell lung cancer increased significantly in the patients with lung cancer. Male gender, old age (> or = 60) and smoking are risk factors of squamous cell carcinoma. Female gender, young age (< 45) and occupational exposure are risk factors of adenocarcinoma.
确定原发性支气管肺癌模式的变化。
我们回顾了原发性支气管肺癌患者的临床资料,这些患者被确定为四川省的常住居民,并于2000年和2010年在四川大学华西医院接受治疗。比较了2000年组和2010年组患者的性别、年龄、城乡居住情况、吸烟史、职业暴露和肿瘤组织学类型的分布。
共有2167例患者(2000年616例,2010年1551例)符合纳入标准。与2000年组相比,2010年组男性患者比例较低(男女比例从2.78:1降至2.13:1,P = 0.013),来自中小城市的患者更多(来自大城市的患者从42.1%降至32.0%,P < 0.001,来自中小城市的患者从39.9%降至31.7%,P < 0.001),来自农村地区的患者更多(来自乡镇的患者从5.5%增至8.1%,P = 0.041,来自村庄的患者从12.5%增至28.2%,P < 0.001)。两组患者的年龄无显著差异。鳞状细胞癌的比例从2000年的44.8%降至2010年的28.7%(P < 0.001)。腺癌的比例从2000年的43.0%增至2010年的53.1%(P < 0.001)。小细胞肺癌的比例从2000年的3.7%增至2010年的11.9%(P < 0.001)。男性患者中鳞状细胞癌的比例高于女性患者(2000年为60.7%对36.6%;2010年为75.8%对42.9%)。腺癌在女性患者中的比例高于男性患者(2000年为60.7%对36.6%;2010年为75.8%对42.9%)。老年患者(≥60岁)中鳞状细胞癌的比例高于年轻患者(<45岁)(2000年为50.5%对33.8%;2010年为30.2%对15.6%)。年轻患者中腺癌的比例高于老年患者(2000年为54.9%对36.9%;2010年为57.1%对51.8%)。鳞状细胞癌在吸烟患者中占主导(2000年为55.6%;2010年为40.9%)。腺癌在不吸烟患者中占主导(2010年为58.4%;2010年为75.7%)以及在有职业暴露风险的患者中占主导(2000年为46.2%;2010年为60.2%)。
在过去十年中,肺癌患者中女性患者、腺癌和小细胞肺癌的百分比显著增加。男性、老年(≥60岁)和吸烟是鳞状细胞癌的危险因素。女性、年轻(<45岁)和职业暴露是腺癌的危险因素。