622例肺癌患者远处转移临床特征的回顾性分析

目的:探讨不同病理类型IV期原发性支气管肺癌的远处转移特点。方法:回顾性分析我科收治的622例诊断明确、资料完整的IV期肺癌患者,比较不同病理类型肺癌患者各器官远处转移发生率,并进行统计学分析。结果:622例IV期肺癌患者中,鳞状细胞癌188例(30.2%),腺癌275例(44.2%),小细胞癌130例(20.9%),大细胞癌5例(0.8%),腺鳞癌14例(2.3%)。平均年龄55.4岁,男女比例为2.60:1,高发年龄为40~60岁。各器官远处转移发生率从高到低依次为:骨267例(42.9%),胸膜212例(34.1%),双肺162例(26.0%),脑148例(23.8%),肝132例(21.2%),肾上腺53例(8.5%),心包50例(8.0%),皮下转移6例(1.0%),肌肉3例(0.5%),眼球和脊髓各1例(0.2%)。单器官转移共283例(45.5%),多器官转移共339例(54.5%),最多为6个器官远处转移。结论:不同病理类型肺癌有各自不同的远处转移特点及临床特征,应选择相应的检查并制定针对性治疗方案。

Metastasis Features of 622 Patients with Stage IV Primary Bronchogenic Carcinoma and Retrospective Analysis of its Relationship with Clinicopathologic Factors

Objective:To investigate the characteristics and regularity of the distant metastasis of stage IV primary bronchogenic carcinoma with different pathological types.Methods:A total of 622 patients with stage IV lung cancer, with complete clinical and pathological data, were investigated retrospectively. The distant metastasis rates of different pathological types of lung cancer were analyzed and compared statistically.Results:Among 622 cases of stage IV lung cancer, there were 188 cases of squamous cell carcinoma (30.2%), 275 cases of adenocarcinoma (44.2%), 130 cases of small cell carcinoma (20.9%), 5 cases of large cell carcinoma (0.8%), 14 cases of adenosquamous carcinoma (2.3%). The average age was 55.4 years old, and the male to female ratio was 2.60:1. Patients of 40 to 60 years old were most vulnerable to lung cancer. The incidence of distant metastases from high to low was: bone metastases in 267 cases (42.9%), pleural metastases in 212 cases (34.1%), double lung metastases in 162 cases (26%), brain metastases in 148 cases (23.8%), liver metastases in 132 cases (21.2%), adrenal metastases in 53 cases (8.5%), pericardial metastases in 50 cases (8%), subcutaneous metastasis in 6 cases (1%), muscle metastases in 3 cases (0.5%), eye and spinal cord metastases each in 1 cases (0.2%). A total of 283 cases had single organ metastasis (45.5%), and the other 339 cases had multiple organ metastasis (54.5%). There was a maximum of 6 distant organs metastasis.Conclusion:The distant metastasis and clinical characteristics were different according to the different pathological subtypes of lung cancer. Physicians should better choose the suitable examination and the pertinence treatment.