539例Ⅳ期肺癌患者首程诊治临床分析

中国辐射卫生

2017, Vol. 26

Issue (3): 372-377

诊断与治疗

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539例Ⅳ期肺癌患者首程诊治临床分析

邵倩, 刘珊珊, 李建彬, 王玮, 张英杰, 李奉祥

山东大学附属肿瘤医院, 山东省肿瘤防治研究院, 山东济南 250117

Clinical Investigation into the Initial Diagnosis and Treatment of 539 Patients with Ⅳ Stage Lung Cancer

SHAO Qian, LIU Shan-shan, LI Jian-bin, WANG Wei, ZHANG Ying-jie, LI Feng-xiang

Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan 250117 China

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摘要目的研究Ⅳ期肺癌患者首程诊治的临床症状、病理分型、转移器官、治疗方法及生存时间等临床特征。方法回顾性分析2009年539例首次诊治Ⅳ期肺癌患者的临床特征，其中男351例（65.1%）、女188例（34.9%）；最大年龄88岁，最小年龄19岁；平均年龄58.51岁，中位年龄59岁，60岁以下282例（52.3%）。主要症状：咳嗽、咳痰、痰中带血、胸痛、胸闷、憋喘、发热及肺外症状如头痛、骨痛等。细胞学和/或病理类型：腺癌、鳞癌、小细胞癌、大细胞癌、腺鳞癌及其他类型癌分别为377例（69.9%）、95例（17.6%）、50例（9.3%）、9例（1.7%）、5例（0.9%）及3例（0.6%）；其中单器官、多器官转移分别为393例（72.9%）、146例（27.1%）；单器官转移中，胸膜、脑、骨、肺、肝、肾上腺转移分别为112例（28.5%）、100例（25.4%）、78例（19.8%）、60例（15.3%）、29例（7.4%）、14例（3.6%）。采用Kaplan-Meier法进行生存分析，多因素Cox回归分析。结果随访率为85.3%，1年、2年、3年生存率分别为64.2%（346例）、19.7%（106例）、1.5%（8例）；肝脏及胸膜转移预后较差，骨转移预后相对较好；多器官转移较单器官转移预后差；多因素分析表明患者的年龄、不同转移器官、转移器官数目及治疗方式是影响生存的独立危险因素。结论 Ⅳ期肺癌患者临床症状多样，无特异性，预后较差，患者的年龄、远处转移部位、转移器官数目及治疗方式是影响生存的主要因素。

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	邵倩
	刘珊珊
	李建彬
	王玮
	张英杰
	李奉祥

关键词 ：肿瘤/肺脏, 诊断, 治疗, 预后, 临床分析

收稿日期: 2016-08-22

PACS:

R816.41

基金资助:2015年山东省重点研发计划项目（2015GSF118027）

通讯作者: 李建彬,Email:lijianbin@msn.com E-mail: lijianbin@msn.com

作者简介: 邵倩(1969-),女,山东单县人,硕士,副主任医师,从事胸部肿瘤的放疗工作。

引用本文:

邵倩, 刘珊珊, 李建彬, 王玮, 张英杰, 李奉祥. 539例Ⅳ期肺癌患者首程诊治临床分析[J]. 中国辐射卫生, 2017, 26(3): 372-377.
SHAO Qian, LIU Shan-shan, LI Jian-bin, WANG Wei, ZHANG Ying-jie, LI Feng-xiang. Clinical Investigation into the Initial Diagnosis and Treatment of 539 Patients with Ⅳ Stage Lung Cancer. , 2017, 26(3): 372-377.

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http://www.zgfsws.com/CN/ 或 http://www.zgfsws.com/CN/Y2017/V26/I3/372

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