Tang Ruke, Lei Yujie, Ye Lianhua, Zhao Guangqiang, Xiang Xudong, Li Gaofeng, Li Guangjian, Wang Xi, Chen Ying, Yang Kaiyun, Chen Xiaobo, Yang Jiapeng, Zhao Min, Xiang Bingquan, Huang Qiubo, Luo Guangcan, Zhang Hongwei, Huang Yunchao
Department of Thoracic Surgery I, Yunnan Cancer Hospital, Kunming 650118, China.
Department of Thoracic Surgery II, Yunnan Cancer Hospital, Kunming 650118, China.
Zhongguo Fei Ai Za Zhi. 2024 Dec 20;27(12):911-918. doi: 10.3779/j.issn.1009-3419.2024.101.33.
Lung cancer is a disease with a high incidence rate in Yunnan province, yet there is a paucity of large-scale studies on its clinical epidemiology. This research aims to investigate the epidemiological characteristics of patients who underwent lung cancer surgery at Yunnan Cancer Hospital over the past decade, thereby providing a theoretical basis for the prevention and treatment of lung cancer.
Clinical data were collected from 15,967 patients who underwent lung cancer surgery at Yunnan Cancer Hospital between 2013 and 2022. A statistical analysis was conducted on the patients' general data, surgical information, pathological types of lung cancer, and other clinical epidemiological characteristics.
Among the 15,967 cases of lung cancer, 46.3% were male and 53.7% were female, with the male-to-female ratio ranging from 0.68 to 1.61:1. The median age was 56 years (interquartile range: 49-63), and 37.0% of the patients were in the age group of 50-59 years. Since 2017, there has been an annual increase in the proportion of patients under the age of 60 years. The smoking status of the patients showed that 28.1% were smokers and 71.9% were non-smokers. Qujing city accounted for 41.4% and Kunming city for 23.2% of the cases in Yunnan province, with 29.6% of patients originating from Xuanwei and Fuyuan areas of Qujing city. The distribution of affected lung lobes was as follows: right upper lobe 28.2%, right middle lobe 6.3%, right lower lobe 20.1%, left upper lobe 22.7%, and left lower lobe 16.4%. The use of thoracoscopic surgery increased from 30.8% to 96.3%, with single-port thoracoscopic surgery comprising 61.3%. Lobectomy was performed in 64.2% of cases, wedge resection in 17.2%, and segmentectomy in 12.2%. The proportion of lobectomy decreased from 83.1% to 46.1%. The proportion of patients in stages 0-I increased from 43.5% to 82.8%, while stages II-IV decreased from 56.5% to 17.2%. Adenocarcinoma increased from 75.6% to 88.3%, and squamous cell carcinoma decreased from 21.5% to 8.6%. Among adenocarcinoma patients, 60.9% were female. Among sguamous cell carcinoma patients, 90.6% were male. The peak age for adenocarcinoma was 50-59 years, and for squamous cell carcinoma, it was 60-69 years. The smoking rate was higher among squamous cell carcinoma patients (65.9%) compared to adenocarcinoma patients (22.3%). Adenocarcinoma patients had a higher proportion in stages 0-I (76.3%), while squamous cell carcinoma patients were more prevalent in stages II-III (64.1%).
The findings indicate an increasing proportion of female patients with adenocarcinoma, a younger age of onset, a higher proportion of non-smoking lung cancer patients, and an increased proportion of stages 0-I lung cancer. These trends may reflect the epidemiological characteristics of patients undergoing lung cancer surgery in Yunnan and surrounding areas over the past decade.
肺癌是云南省发病率较高的疾病，但关于其临床流行病学的大规模研究较少。本研究旨在调查过去十年在云南省肿瘤医院接受肺癌手术患者的流行病学特征，从而为肺癌的防治提供理论依据。
收集2013年至2022年期间在云南省肿瘤医院接受肺癌手术的15967例患者的临床资料。对患者的一般资料、手术信息、肺癌病理类型及其他临床流行病学特征进行统计分析。
在15967例肺癌病例中，男性占46.3%，女性占53.7%，男女比例为0.68至1.61:1。中位年龄为56岁（四分位间距：49 - 63岁），37.0%的患者年龄在50 - 59岁之间。自2017年以来，60岁以下患者的比例逐年增加。患者的吸烟状况显示，28.1%为吸烟者，71.9%为非吸烟者。曲靖市占云南省病例的41.4%，昆明市占23.2%，29.6%的患者来自曲靖市宣威和富源地区。患侧肺叶分布如下：右上叶28.2%，右中叶6.3%，右下叶20.1%，左上叶22.7%，左下叶16.4%。胸腔镜手术的使用率从30.8%增至96.3%，其中单孔胸腔镜手术占61.3%。64.2%的病例进行了肺叶切除术，17.2%进行了楔形切除术，12.2%进行了肺段切除术。肺叶切除术的比例从83.1%降至46.1%。0 - I期患者的比例从43.5%增至82.8%，而II - IV期从56.5%降至17.2%。腺癌从75.6%增至88.3%，鳞状细胞癌从21.5%降至8.6%。腺癌患者中60.9%为女性。鳞状细胞癌患者中90.6%为男性。腺癌的发病高峰年龄为50 - 59岁，鳞状细胞癌为60 - 69岁。鳞状细胞癌患者的吸烟率（65.9%）高于腺癌患者（22.3%）。腺癌患者在0 - I期的比例较高（76.3%），而鳞状细胞癌患者在II - III期更为常见（64.1%）。
研究结果表明，腺癌女性患者比例增加、发病年龄年轻化、非吸烟肺癌患者比例升高以及0 - I期肺癌患者比例增加。这些趋势可能反映了过去十年云南及周边地区接受肺癌手术患者的流行病学特征。
