祝爱峰

[摘要] 目的 分析青年肺癌临床误诊原因、病理特点、治疗方式及疗效。 方法 2002年1月～2009年12月年收治青年肺癌患者115例。本研究患者中56例曾误诊。手术治疗42例，68例因不能手术或不愿手术而选择化学治疗或放射治疗，2例服中药治疗，3例未做任何治疗。 结果 手术治疗42例中无一例死亡，治疗过程中有12例出现转移，其中肺转移1例，肝转移2例，脑转移6例，脊椎转移3例；1年、3年和5年生存率分别为61.2％、37.3％和11.3％。结论 青年肺癌误诊率高，病理分型以小细胞肺癌和腺癌多见，恶性程度较高，预后较差，但综合治疗近期效果良好，早期发现，早期诊断，早期综合治疗尤为重要。

[关键词] 肺癌；青年；误诊；综合治疗

[中图分类号] R734.2???[文献标识码] B???[文章编号] 2095-0616（2012）15-184-02

Clinical analysis and diagnostic of 115 patients with lung cancer

ZHU?Aifeng

Department of Radiation Oncology, the People's Hospital of Laiwu City in Shandong Province, Laiwu 271100,China

[Abstract] Objective To analyze the misdiagnostic causes,pathological characteristics,therapeutic pattern and efficacy of lung cancer in the young. Methods 115 patients with lung cancer from Jan 2002 to Dec 2009 were treated in our hospital. In this study, 56 cases have been misdiagnosed. There were 42 patients accepted surgical treatment,and 68 cases practised radiotherapy or chemotherapy, and 2 cases choosed traditional Chinese medicine therapy,and 3 cases gived up. Results 42 cases were treated with surgical treatment with no death.There were 12 case metastasized in the course of therapy. The 1-year, 3-year,and 5-year survival rates were 61.2%,37.3% and 11.3% respectively. Conclusion The lung cancer in the young were easily misdiagnosed, and the small cell lung cancer were common pathological type. It is extremely important for these patients to acquired early diagnosis and early appropriate therapy.

[Key words] Lung cancer; Young; Misdiagnosis; Combined therapy

肺癌常见于中老年人，但青年人原发性肺癌也不少见，据统计青年肺癌发病率逐年上升，已成为威胁青年人生命健康的重大疾病[1]。笔者所在医院放疗科2002年1月～2009年12月共收治青年肺癌115例，笔者从青年肺癌的误诊原因、病理类型、治疗方式进行了分析，现报道如下。

1?资料与方法

1.1?一般资料

115例患者中，男82例，女33例，年龄21～39岁，平均（33.4±2.5）岁。吸烟者32例，其中男性29例，女性3例。临床表现：咳嗽38例，咳嗽伴痰中带血21例，声音嘶哑18例，胸痛、胸闷症状12例，锁骨上淋巴结肿大13例；查体发现13例。

1.2?诊断方法

所有患者经过透视、X光片及CT或MRI检查，其中，中心型肺癌79例，周围型肺癌36例。中心型肺癌主要影像表现为肺门团块，支气管狭窄、梗阻或管内占位，常合并肺不张或阻塞性肺炎，周围型肺癌可表现为肺外周圆形或椭圆形肿块结节，边缘可见浅分叶，小毛刺和棘状突起等，有的肿块内可见少量钙化及偏心性空洞；……