临床荟萃

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慢性阻塞性肺疾病合并肺癌的临床特点分析

  

  1. 1.山东省医学科学院附属济宁市第一人民医院 呼吸内科,山东 济宁 272100;
    2.济南大学 山东省医学科学院医学与生命科学学院,山东 济南 250022
  • 出版日期:2017-12-05 发布日期:2017-12-14
  • 通讯作者: 通信作者:刘瑞娟, Email: mqb_6@163.com

Clinical features of chronic obstructive pulmonary disease with lung cancer

  1. 1.Department of Respiratory Medicine, Jining First People's Hospital affiliated to Shandong Academy
    of Medical Sciences, Jining 272100,China; 2.School of Medicine and Life Sciences, University of Jinan,
    Shandong Academy of Medical Sciences,  Jinan 250022,China
  • Online:2017-12-05 Published:2017-12-14
  • Contact: Corresponding author: Liu Ruijuan, Email: mqb_6@163.com

摘要: 目的  分析慢性阻塞性肺疾病(COPD)合并肺癌患者的临床特点,提高临床对COPD合并肺癌的认识。方法  回顾性分析COPD合并肺癌患者98例和同期住院单纯COPD患者108例,对两组患者临床资料进行统计学分析。结果  COPD合并肺癌组患者的咯血或痰中带血、胸痛、肺不张、声音嘶哑、胸腔积液、消瘦均显著高于单纯COPD组患者 (P<0.05);COPD合并肺癌组男性患者显著多于单纯COPD组(86.7% vs 71.3%,P<0.05);单纯COPD组患者年龄高于COPD合并肺癌组(P<0.01);COPD合并肺癌组吸烟指数显著高于单纯COPD组(P<0.01);COPD合并肺癌组患者肺功能分级在Ⅰ 级、Ⅱ级的人数显著多于单纯COPD组(62.9% vs 54.3%,P=0.047;78.7% vs 21.3%,P<0.01);COPD合并肺癌组的患者,肺鳞癌比例最高(43.9%),男性以肺鳞癌常见(48.2%),女性以肺腺癌多见(53.8%)。结论  当具有COPD病史的患者出现咯血或痰中带血、胸痛、肺不张、声音嘶哑、胸腔积液、消瘦的临床表现及体征时,要注意警惕合并肺癌的可能。COPD合并肺癌好发于男性大量吸烟的患者,气道阻塞较轻的COPD患者容易发生肺癌,病理类型以肺鳞癌最常见。

关键词: 肺疾病, 阻塞性, 肺肿瘤, 体征和症状

Abstract: Objective  In order to analyze the clinical characteristics of patients with chronic obstructive pulmonary disease (COPD) and lung cancer, to improve the clinical understanding of COPD with lung cancer. Methods  Retrospective analysis was performed in 98 patients of COPD with lung cancer and the same pospitalized period 108 patients with simple COPD. The clinical data of two groups were analyzed with statistics. Results  COPD combined with lung cancer patients were significantly higher in hemoptysis or sputum bloody, chest pain, atelectasis, hoarseness, pleural effusion, weight loss than patients with COPD alone (P<0.05);The male patients with COPD combined with lung cancer were significantly more than COPD alone(86.7% vs 71.3%,P<0.05);Patients with COPD were older than COPD with lung cancer (P<0.01);The smoking index of COPD with lung cancer group was significantly higher than that of COPD alone (P<0.01);The lung function classification of COPD patients with lung cancer group in the first and second grade were significantly more than those of COPD alone(62.9% vs 54.3%,P=0.047;78.7% vs 21.3%,P<0.01);COPD patients with lung cancer group, the highest proportion of lung squamous cell carcinoma (43.9%), men with lung squamous cell carcinoma was common (48.2%), women with lung adenocarcinoma was more common (53.8%). Conclusion  When patients with  a history of COPD had hemoptysis or sputum bloody, chest pain, atelectasis, hoarseness, pleural effusion, weight loss of clinical manifestations and signs, the possibility of lung cancer  should be alerted. COPD combined with lung cancer occurs in a large number of male patients with smoking, airway obstruction in patients with COPD prone to lung cancer, lung squamous cell carcinoma is the most common pathological type.

Key words: pulmonary disease, obstructive;lung neoplasms;signs and symptoms