Baughman R P, Gunther K L, Buchsbaum J A, Lower E E
Department of Internal Medicine, University of Cincinnati Medical Center, Ohio, USA.
Clin Exp Rheumatol. 1998 Jan-Feb;16(1):21-6.
Clubbing can be a paraneoplastic manifestation of bronchogenic carcinoma. We assessed a new digital index of clubbing and used it to determine the prevalence of clubbing for different cell types of lung cancer.
Clubbing was assessed by measurement of the thickness of both the base of the nailbed (distal phalangeal depth--DPD) and the distal interphalangeal depth (IPD) of the index finger in a control group compared to patient groups with either chronic obstructive lung disease, or lung cancer.
Of the 55 normal subjects, no patient had a DPD/IPD ratio of more than 1.05 on either hand, while 11% of the patients with COPD had a ratio of more than one. For the cancer patients, 33% had a ratio greater than one, with 30 of 109 (37%) having a ratio > 1.05 (chi(2) = 17.6, p < 0.0001). There was no difference in the prevalence of clubbing between the 33 squamous cell patients, the 43 adenocarcinoma patients, and the 33 small cell lung carcinoma patients included.
Measurement of the interphalangeal and distal phalangeal distance demonstrated that one-third of patients with lung cancer had evidence of clubbing. The type of bronchogenic carcinoma did not appear to affect the proportion of patients with clubbing.
杵状指可能是支气管肺癌的一种副肿瘤表现。我们评估了一种新的杵状指数字指数，并使用它来确定不同细胞类型肺癌患者中杵状指的患病率。
在对照组中，通过测量食指甲床底部（远节指骨深度——DPD）和远侧指间关节深度（IPD）来评估杵状指，并与慢性阻塞性肺疾病患者组或肺癌患者组进行比较。
55名正常受试者中，双手的DPD/IPD比值均无超过1.05的情况，而慢性阻塞性肺疾病患者中有11%的比值超过1。对于癌症患者，33%的患者比值大于1，109名患者中有30名（37%）比值>1.05（χ² = 17.6，p < 0.0001）。纳入研究的33例鳞状细胞癌患者、43例腺癌患者和33例小细胞肺癌患者之间杵状指的患病率没有差异。
指间关节和远节指骨距离的测量表明，三分之一的肺癌患者有杵状指的证据。支气管肺癌的类型似乎不影响杵状指患者的比例。
