2011 - 2015年华东地区一家三级甲等医院新诊断肺癌的临床特征及趋势分析
Clinical profiles and trend analysis of newly diagnosed lung cancer in a tertiary care hospital of East China during 2011-2015.
作者信息
Wang Pingli, Zou Jixia, Wu Jingni, Zhang Chengyan, Ma Chengxi, Yu Juan, Zhou You, Li Baizhou, Wang Kai
机构信息
Department of Respiratory and Critical Care Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
Department of Pathology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China.
出版信息
J Thorac Dis. 2017 Jul;9(7):1973-1979. doi: 10.21037/jtd.2017.06.102.
BACKGROUND
More than one-third of lung cancer worldwide occurring in China. However, the clinical profiles of lung cancer patients in the mainland of China are rarely reported and largely unknown. The objective of this study is to analyze the characteristics and time trends of newly diagnosed lung cancer cases during the past 5 years in East China.
METHODS
The data came from an academic tertiary care hospital of East China. Patients who were newly diagnosed as lung cancer from 2011 to 2015 were enrolled. All new cases got pathological supports by lung biopsy or surgery. Tumor staging was performed according to the seventh edition of the tumor node metastasis (TNM) classification of malignant tumors. The patients' disease information was collected from the database of the hospital information system (HIS).
RESULTS
From 2011 to 2015, aggregately 5,779 patients, including 3,719 males and 2,060 females, were diagnosed as lung cancer. The major histologic subtypes of lung cancer were adenocarcinoma (ADC, 60.0%), squamous cell carcinoma (SCC, 25.6%), small cell lung cancer (SCLC, 8.5%), large cell carcinoma (0.6%), adenosquamous carcinoma (1%), other non-small cell carcinoma (1.6%) and unclassified or rare carcinoma (2.8%). ADC proportion of female was much higher than that of male. A higher proportion of advanced stage (stage IIIB, IV) of lung cancer existed in patients who were admitted to hospital due to respiratory or cancer related symptoms (RCRS) than those without RCRS. Smoking rate in male patients reached 80.2%, while it was only 2.7% in females. EGFR mutation existed in 66% of female and 37% of male patients with ADC.
CONCLUSIONS
This study demonstrates the clinicopathologic characteristics of lung cancer patients from East China, including histologic composition, staging proportion, smoking prevalence and gene mutation status. During the past 5 years, the proportion of ADC has increased gradually whereas SCC decreased.
背景
全球超过三分之一的肺癌发生在中国。然而，中国大陆肺癌患者的临床特征鲜有报道，在很大程度上尚不为人知。本研究的目的是分析中国东部地区过去5年新诊断肺癌病例的特征和时间趋势。
方法
数据来自中国东部一家学术性三级医疗机构。纳入2011年至2015年新诊断为肺癌的患者。所有新病例均通过肺活检或手术获得病理支持。根据恶性肿瘤的肿瘤淋巴结转移（TNM）分类第七版进行肿瘤分期。患者的疾病信息从医院信息系统（HIS）数据库中收集。
结果
2011年至2015年，共有5779例患者被诊断为肺癌，其中男性3719例，女性2060例。肺癌的主要组织学亚型为腺癌（ADC，60.0%）、鳞状细胞癌（SCC，25.6%）、小细胞肺癌（SCLC，8.5%）、大细胞癌（0.6%）、腺鳞癌（1%）、其他非小细胞癌（1.6%）以及未分类或罕见癌（2.8%）。女性ADC的比例远高于男性。因呼吸或癌症相关症状（RCRS）入院的肺癌患者中晚期（IIIB期、IV期）的比例高于无RCRS的患者。男性患者的吸烟率达到80.2%，而女性仅为2.7%。女性ADC患者中66%存在表皮生长因子受体（EGFR）突变，男性患者中这一比例为37%。
结论
本研究展示了中国东部肺癌患者的临床病理特征，包括组织学构成、分期比例、吸烟率及基因突变状态。在过去5年中，ADC的比例逐渐上升，而SCC的比例下降。
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