CAJ | 학술논문

背景与目的：肺癌是目前我国乃至全球发病率和死亡率最高的恶性肿瘤，多数患者在60岁之后发病，因此对老年患者行肺癌手术是临床非常值得关注的问题。本研究探讨上海肺科医院行肺癌切除手术的老年与中年肺癌患者的临床特征、流行病学特点及围手术期的情况，为临床诊疗提供参考。方法：回顾性分析2007年1月—2012年12月在上海市肺科医院胸外科住院并接受手术的1019例肺癌患者，比较老年组和中年组在性别、病理类型、TNM分期、术中出血量及术后住院天数等方面的差异。结果：两组性别分布差异有统计学意义(P＜0.05)，和中年组相比，老年组男性比例更高(76.91%vs 52.81%)。在病理类型上，两组均为腺癌最多、鳞癌次之，但病理类型构成比差异有统计学意义(P＜0.05)，老年组鳞癌的比例较中年组高(37.5%vs 15.6%)，腺癌的比例较中年组低(50.7%vs 72.8%)。在临床分期构成比上，老年组病例中Ⅱa、Ⅱb、Ⅲa期的比例高于中年组，中年组病例中Ⅰa、Ⅰb期的比例高于老年组(P＜0.05)。老年组患者术中出血量及术后住院天数均高于中年组患者，两组患者的术后平均住院时间差异有统计学意义(P＜0.05)。两组伴随疾病差异有统计学意义(P＜0.05)，老年组伴随疾病的比例高于中年组(58.6%vs 42.3%)。结论：老年肺癌患者男性较多，病理类型以腺癌较多，来院就诊时以中晚期多见，术中出血量、术后住院天数均多于中年肺癌患者。
배경여목적：폐암시목전아국내지전구발병솔화사망솔최고적악성종류，다수환자재60세지후발병，인차대노년환자행폐암수술시림상비상치득관주적문제。본연구탐토상해폐과의원행폐암절제수술적노년여중년폐암환자적림상특정、류행병학특점급위수술기적정황，위림상진료제공삼고。방법：회고성분석2007년1월—2012년12월재상해시폐과의원흉외과주원병접수수술적1019례폐암환자，비교노년조화중년조재성별、병리류형、TNM분기、술중출혈량급술후주원천수등방면적차이。결과：량조성별분포차이유통계학의의(P＜0.05)，화중년조상비，노년조남성비례경고(76.91%vs 52.81%)。재병리류형상，량조균위선암최다、린암차지，단병리류형구성비차이유통계학의의(P＜0.05)，노년조린암적비례교중년조고(37.5%vs 15.6%)，선암적비례교중년조저(50.7%vs 72.8%)。재림상분기구성비상，노년조병례중Ⅱa、Ⅱb、Ⅲa기적비례고우중년조，중년조병례중Ⅰa、Ⅰb기적비례고우노년조(P＜0.05)。노년조환자술중출혈량급술후주원천수균고우중년조환자，량조환자적술후평균주원시간차이유통계학의의(P＜0.05)。량조반수질병차이유통계학의의(P＜0.05)，노년조반수질병적비례고우중년조(58.6%vs 42.3%)。결론：노년폐암환자남성교다，병리류형이선암교다，래원취진시이중만기다견，술중출혈량、술후주원천수균다우중년폐암환자。
Background and purpose:The morbidity and mortality of lung cancer are currently the highest malignant tumor in China and the world. Most onset age of the illness is after 60 years old. Therefore, surgical resection of lung cancer in the elderly is very worthy of concern. This study aimed to investigate the clinical features, epidemic characteristics and conditions in perioperative period between the elderly and middle-aged patients with lung cancer, and provide the reference for clinical treatment.Methods:Totally 1 019 patients with lung cancer who were admitted to the hospital and accepted the operations in department of thoracic surgery in Shanghai Pulmonary Hospital from Jan. 2007 to Dec. 2012 were analysed retrospectively. The clinical data including gender, pathological type, TNM stage, intraoperative amount of bleeding and post-operative length of hospitalization were compared.Results:There was a signiifcant difference in sexual factors between these two groups (P?0.05), and compared with the middle-aged group, the proportion of male was more higher in the elderly group (76.91%vs 52.81%). Adenocarcinoma was the most common and squamous carcinoma was the next in both two groups. The constituent ratio of the pathlogical type between the elderly group and the middle-aged group was statistically signiifcant (P?0.05). The squamous carcinoma in the elderly group was higher than that in the middle-aged group (37.5%vs 15.6%). On the contrary, adenocarcinoma was more common in the middle-aged group (72.8%vs 50.7%). StagesⅡa,Ⅱb, andⅢa were more common in the elderly group and stagesⅠa, andⅠb were the most clinical stage in the middle-aged group. The clinical stage between two groups was statistically significant (P?0.05).The intraoperative amount of bleeding was higher and the post-operative length of hospitalization was longer in the elderly group, with a signiifcant difference as compared with that in the middle-aged group(P?0.05). And there was a signiifcant difference in incidence of accompanying diseases between the two groups, compared with the middle-aged group, the proportion of accompanying diseases was more higher in the elderly group(58.6%vs42.3%).Conclusion:Elderly patients with lung cancer are more common in males, with adenocarcinoma being the most common. The cancer mostly belongs to a medium or advanced stage. Elderly patients have the trend with more amount of bleeding in operation and lengh of stay.