| Objective Analyze the clinical characteristics of patients with chronic obstructive pulmonary disease(COPD)with lung cancer,explore the relationship between impaired lung function and degree of emphysema and the incidence and prognosis of COPD with lung cancer,look for risk factors that affect the prognosis of patients with COPD and lung cancer,and identify early COPD patients with lung cancer and improve the prognosis of COPD patients with lung cancer.Methods Choice in October 2013 to December 2017,Ningxia Hui Autonomous Region People’s Hospital admitted 80 cases of COPD patients with NSCLC(group A),COPD patients(group B),and NSCLC patients(group C).Collect the general information,clinical symptoms,tumor TNM stage,pathological type,lung function,emphysema score,airway wall thickness,airway cavity diameter,airway wall area as a percentage of the total airway cross-sectional area,Laboratory examination and other indicators,retrospectively analyze the clinical characteristics of patients with COPD and lung cancer,and further search for risk factors that affect the prognosis of patients with COPD and NSCLC.Results 1.Comparison of 80 cases of COPD patients with NSCLC(group A),COPD patients(group B),and NSCLC patients(group C)in each of the three groups: the average age of patients in group A is older(65.67±8.86 years),mostly male(82.5%),smoking index is high(20(50)),sputum expectoration symptoms are obvious,COPD-LUCSS-DLCO score is high(7(3.5)),which is statistically significant compared with B and C groups(P<0.05);Adenocarcinoma is the predominant type in group A and C(42.5% vs.60%),the peripheral type is predominant in group A(accounting for 51.25%),and there are more cases in TNM stage III+IV(63.75% vs.40%),the difference was statistically significant(P<0.05).Comparing group A with group B,there are 54 patients with GOLD grade 1 and II in group A,26 patients with grade III and IV,accounting for 67.5% and 32.5% of the total number of group A,respectively,and group B patients with grade 1 and II There were 46 cases,34 cases of grade III and grade IV,accounting for 57.5% and 42.5% of the total number of group A respectively,the difference was statistically significant(P<0.05).2.All 80 patients in group A died before follow-up;39 died and 39 survived in group B;63 died and 8 survived in group C.The 3-year survival rate in group A was 22.5%,the 3-year survival rate in group B was 76.9%,and the 3-year survival rate in group C was 33.8%;with the increase in years,the survival rate gradually decreased,with the largest decline in group A and the smallest in group B.3.Age,EI,WA%,Goddard score,FEV1,RV/TLC are associated with the risk of lung cancer in COPD,and age,EI,WA%,FEV1 are negatively correlated with the risk of lung cancer,Goddard score,RV/TLC risk of lung cancer Positive correlation.4.Gender,treatment,Goddard score,TNM stage,neuron-specific enolase are linearly related to the survival time of COPD patients with lung cancer;women,chemotherapy,and surgical treatment are positively related to survival time,Goddard score,neuron specificity Sex enolase is negatively correlated with the survival time of COPD patients with lung cancer.Conclusion: 1.COPD and NSCLC have more men,older age of onset,and higher smoking index;clinical sputum symptoms are more obvious,adenocarcinoma is more common,peripheral type is common,TNM staging is mainly stage III+IV,lung function test Most of them are GOLD I and II,and the COPDLUCSS-DLCO score is higher.2.The 3-year survival rate of patients with COPD and NSCLC is only 22.5%,which is worse than the prognosis of patients with NSCLC alone.3.For the risk factors of COPD and NSCLC,Goddard score,WA%,FEV1,RV/TLC are more important among many factors.4.The overall survival time of patients with COPD and NSCLC is related to Goddard score and neuron-specific enolase.5.Emphysema visible on chest CT is a risk factor for COPD patients to develop NSCLC,and it is also a predictor of poor prognosis for COPD patients with NSCLC. |
PDF Full Text Request