Lin Yanping, Zhang Qiang, Lu Yanni, Huang Yunchao, Ma Jie, Zhou Yongchun
Department of Yunnan Cancer Center, Yunnan Cancer Hospital/The Third Affiliated Hospital of Kunming Medical University/Yunnan Cancer Center, Kunming 650118, China.
Zhongguo Fei Ai Za Zhi. 2020 Mar 20;23(3):142-149. doi: 10.3779/j.issn.1009-3419.2020.03.05. Epub 2020 Feb 27.
Yunnan is a country with a high incidence of lung cancer in China and all over the world, and its morbidity and mortality are still rising. With changes in lifestyle and environment, the clinical epidemiological characteristics of lung cancer are converting. However, the trend of clinical characteristics of lung cancer in Yunnan has not been reported in the past 10 years, and we should start further research. The aim of this study was to explore the clinical characteristics and changes of lung cancer in Yunnan from 2005 to 2014, and to provide a theoretical basis for lung cancer prevention and treatment in this region.
A retrospective survey was used to extract the cases of lung cancer patients who were treated in our hospital from 2005 to 2014 by simple random sampling. The sociodemographic and clinicopathological characteristics of the patients were extracted by using a unified and standardized questionnaire. And the statistical analysis of the data was performed.
A total of 1,000 patients with lung cancer were enrolled, with an average age of (58.1±10.1) years, and the ratio of male to female was 3.08/1.00. The proportion of male patients decreased from 75.0% in 2005 to 66.0% in 2014, while female patients increased from 25.0% to 34.0% (P=0.007). The proportion of patients aged ≥60 years increased from 30.0% in 2005 to 39.0% in 2014, and the proportion of patients under 60 years of age decreased, but there was no statistical difference (P=0.532). The proportion of patients with lower levels of education (primary or junior high school) increased from 36.0% to 66.0% (P<0.001). The proportion of smokers decreased from 71.0% to 47.0%, and the number of non-smokers increased from 29.0% to 52.0% (P=0.003). The patients with advanced lung cancer (IIIb-IV) increased from 20.0% to 54.0%, while the proportion of stage II-IIIa decreased from 62.0% to 24.0% (P=0.002). The proportion of adenocarcinoma increased from 36.0% to 61.0%, while squamous cell carcinoma decreased from 32.0% to 27.0% (P<0.001). Chest X-ray applications decreased from 91.0% to 58.0% (P<0.001), while chest computed tomography (CT) usage increased from 46.0% to 89.0% (P<0.001). Head magnetic resonance imaging (MRI) usage increased from 1.0% to 15.0% (P<0.001). The bone scan increased from 35.0% to 78.0% (P<0.001). The positron emission tomography-CT (PET-CT) inspection technique increased significantly from 0.0% to 17.0%. Chemotherapy (P=0.67) and surgery (P=0.78) were the most common treatments and the treatments were unchanged over the past 10 years.
The proportion of female patients increased, the clinical stage was late, and the pathological type transformation was a major challenge in the prevention and treatment of lung cancer in Yunnan. Despite major changes in sociodemographic and clinicopathological features, the choice of primary treatment modalities has not changed, and further research is needed.
在中国乃至全球,云南省都是肺癌高发地区,其发病率和死亡率仍在上升。随着生活方式和环境的变化,肺癌的临床流行病学特征正在转变。然而,过去10年云南肺癌临床特征的变化趋势尚无报道,我们应展开进一步研究。本研究旨在探讨2005年至2014年云南肺癌的临床特征及变化,为该地区肺癌的防治提供理论依据。
采用回顾性调查,通过简单随机抽样提取2005年至2014年在我院接受治疗的肺癌患者病例。使用统一标准化问卷提取患者的社会人口学和临床病理特征,并对数据进行统计分析。
共纳入1000例肺癌患者,平均年龄(58.1±10.1)岁,男女比例为3.08/1.00。男性患者比例从2005年的75.0%降至2014年的66.0%,而女性患者比例从25.0%增至34.0%(P=0.007)。≥60岁患者比例从2005年的30.0%增至2014年的39.0%,60岁以下患者比例下降,但差异无统计学意义(P=0.532)。低教育水平(小学或初中)患者比例从36.0%增至66.0%(P<0.001)。吸烟者比例从71.0%降至47.0%,非吸烟者比例从29.0%增至52.0%(P=0.003)。晚期肺癌(IIIb-IV期)患者比例从20.0%增至54.0%,而II-IIIa期比例从62.0%降至24.0%(P=0.002)。腺癌比例从36.0%增至61.0%,鳞状细胞癌比例从32.0%降至27.0%(P<0.001)。胸部X线检查应用比例从91.0%降至58.0%(P<0.001),而胸部计算机断层扫描(CT)应用比例从46.0%增至89.0%(P<0.001)。头部磁共振成像(MRI)应用比例从1.0%增至15.0%(P<0.001)。骨扫描比例从35.0%增至78.0%(P<0.001)。正电子发射断层扫描-CT(PET-CT)检查技术从0.0%显著增至17.0%。化疗(P=0.67)和手术(P=0.78)是最常见的治疗方式,且在过去10年中治疗方式未变。
女性患者比例增加、临床分期偏晚以及病理类型转变是云南肺癌防治面临的主要挑战。尽管社会人口学和临床病理特征发生了重大变化,但主要治疗方式的选择并未改变,仍需进一步研究。