Gong Shuning, Sang Chongling, Xu Zhiyong, Wang Yuhong
Department of Respiratory Medicine, No. 322 Hospital of the People's Liberation Army, Datong 037006, China.
Zhongguo Fei Ai Za Zhi. 2014 Jun 20;17(6):465-8. doi: 10.3779/j.issn.1009-3419.2014.06.05.
It has been proven that lung cancer in the youth exhibited rapid progression, thus timely and accurate diagnosis is crucial. The aim of this study is to explore the clinicopathological characteristics of lung cancer in the youth, so as to provide clues for diagnosis.
The study enrolled patients aged younger than 40 years with lung cancer diagnosed with histology or cytology in our hospital between 1995-2012. We retrospectively analyzed sex, age, symptoms, smoking history, histology, stage and misdiagnosis.
One hundred and thirty patients with lung cancer in the youth were enrolled, which comprise 5.2% of all cases of lung cancer in that period. Among them, 68.5% were male; 53.8% were aged between 36 and 40 years. Common symptoms included cough and hemoptysis, and systematic symptoms were relatively uncommon; and 11.8% showed no symptoms. 63.3% had a smoking history, and the time between initial symptom and final diagnosis averaged 3.9 months. The misdiagnosis rate was 51.5%, with tuberculosis as the leading misdiagnosis. 85.4% were staged III/IV. Primary lesion often located in upper lobes. Adenocarcinoma was the commonest histology, and 72.3% of the whole group was poorly differentiated.
Lung cancer in the youth showed some special clinicopathological characteristics. Doctors should consider the possibility of lung cancer in patients with seemly diagnosis of tuberculosis, especially in those without symptomatic symptoms, and perform histological or cytological examinations. The absence of smoking history cannot rule out the possibility of lung cancer in youth patients.
已证实青年肺癌进展迅速,因此及时准确的诊断至关重要。本研究旨在探讨青年肺癌的临床病理特征,为诊断提供线索。
本研究纳入了1995年至2012年间在我院经组织学或细胞学确诊为肺癌的40岁以下患者。我们回顾性分析了患者的性别、年龄、症状、吸烟史、组织学类型、分期及误诊情况。
共纳入130例青年肺癌患者,占同期所有肺癌病例的5.2%。其中,男性占68.5%;53.8%的患者年龄在36至40岁之间。常见症状包括咳嗽和咯血,全身症状相对少见;11.8%的患者无症状。63.3%的患者有吸烟史,从出现初始症状到最终确诊的平均时间为3.9个月。误诊率为51.5%,主要误诊为肺结核。85.4%的患者分期为III/IV期。原发灶常位于上叶。腺癌是最常见的组织学类型,全组72.3%为低分化。
青年肺癌表现出一些特殊的临床病理特征。医生对于疑似肺结核的患者,尤其是无症状患者,应考虑肺癌的可能性,并进行组织学或细胞学检查。无吸烟史不能排除青年患者患肺癌的可能性。