CAJ | 학술논문

目的探讨慢性阻塞性肺疾病(COPD)与支气管肺癌的临床关系,指导临床早期诊断和治疗COPD合并支气管肺癌.方法回顾性分析2012年1月至2013年6月就诊的72例COPD合并支气管肺癌患者的临床资料,包括年龄、性别、吸烟史、肿瘤史、呼吸疾病家族史、病理分型及分期、临床症状和体征及治疗方法等.选出72例单纯肺癌组患者作为对照.采用SPSS 17.0统计软件对两组病例的临床资料进行统计学分析.结果 ①COPD合并肺癌组平均年龄、吸烟史、既往有呼吸疾病家族史、肿瘤家族史均高于单纯肺癌组患者(P＜0.05),两组患者的临床肺癌分期比较差异无统计学意义(P＞0.05).②COPD合并肺癌组中最常见的临床症状和体征:干咳、声音嘶哑、胸膜腔积液、骨痛与单纯肺癌组比较,差异无统计学意义(P＞0.05),而痰中带血、胸痛、呼吸困难、发热和肺不张与单纯肺癌组比较差异有统计学意义(P＜0.05).③两组病理类型比较中小细胞癌、腺癌、其他非小细胞癌类型比较差异有统计学意义(P＜0.05),而两组鳞癌病理类型比较差异无统计学意义(P＞0.05).单纯肺癌组以外科手术治疗为主,COPD合并肺癌组以非手术治疗为主.结论 COPD合并支气管肺癌临床症状缺乏特异性,早期确诊率低,COPD患者有长期吸烟史,伴胸痛、血痰、咳嗽性质的改变、胸腔积液、发热、肺不张应警惕合并肺癌可能.
목적 탐토만성조새성폐질병(COPD)여지기관폐암적림상관계,지도림상조기진단화치료COPD합병지기관폐암.방법 회고성분석2012년1월지2013년6월취진적72례COPD합병지기관폐암환자적림상자료,포괄년령、성별、흡연사、종류사、호흡질병가족사、병리분형급분기、림상증상화체정급치료방법등.선출72례단순폐암조환자작위대조.채용SPSS 17.0통계연건대량조병례적림상자료진행통계학분석.결과 ①COPD합병폐암조평균년령、흡연사、기왕유호흡질병가족사、종류가족사균고우단순폐암조환자(P＜0.05),량조환자적림상폐암분기비교차이무통계학의의(P＞0.05).②COPD합병폐암조중최상견적림상증상화체정:간해、성음시아、흉막강적액、골통여단순폐암조비교,차이무통계학의의(P＞0.05),이담중대혈、흉통、호흡곤난、발열화폐불장여단순폐암조비교차이유통계학의의(P＜0.05).③량조병리류형비교중소세포암、선암、기타비소세포암류형비교차이유통계학의의(P＜0.05),이량조린암병리류형비교차이무통계학의의(P＞0.05).단순폐암조이외과수술치료위주,COPD합병폐암조이비수술치료위주.결론 COPD합병지기관폐암림상증상결핍특이성,조기학진솔저,COPD환자유장기흡연사,반흉통、혈담、해수성질적개변、흉강적액、발열、폐불장응경척합병폐암가능.
Objective To investigate the clinical relationship between patients with chronic obstructive pulmonary disease (COPD)and bronchial carcinoma,in order to provide guidance for early diagnosis and treatment of this comorbidity.Methods The clinical data of 72 cases of COPD combined with bronchial carcinoma who treated in our hospital between January 2012 and June 2013,including age,sex,smoking history,tumor history,past respiratory disease history,symptoms and signs,pathological types and pathological stages,treatment of the carcinoma were retrospectively reviewed.The control group included 72 patients with only bronchial carcinoma.The clinical data were analyzed using the SPSS 17.0.Results ①The average age,smoker histories,past histories of respiratory diseases and family histories of cancer in the study group were higher than those of the control group (P ＜ 0.05).The clinical stages of bronchial carcinoma between the study and control group were no significant difference (P ＞ 0.05).②The most common clinical symptoms and signs in the study group included cough,hoarseness,pleural effusion,bone pain,which showed no significant difference from the control group (P ＞ 0.05).There were statistically significant differences in blood in phlegm,chest pain,dyspnea,fever and pulmonary atelectasis between the study and control groups(P ＜ 0.05).③There were statistically significant differences in pathological types of small cell carcinoma and adenocarcinoma and non-small cell carcinoma between the study and control groups (P ＜ 0.05).The squamous cell carcinoma pathological type showed no significant difference between them (P ＞ 0.05).The control group was given priority to surgery treatment.The study group was major given non-surgical treatment.Conclusions This comorbidity of COPD-combined bronchial carcinoma lacks specific manifestations and has low early diagnosis rate.COPD patients with long smoking history,chest pain,hemoptysis,the change of cough quality,pleural effusions,fever,atelectasis may be predisposed to have bronchial carcinoma.