In Advanced Primary Lung Cancer Phegm Syndrome Characteristics And Quantify The Discriminant Points Study

Primary lung cancer is one of the most common cancer in the world, and is one of the few tumors continued to increase in the incidence. Biological characteristics of lung cancer is complex, high degree of malignant, in 80% of patients with confirmed was in advanced. Western medicine believes that 5-year survival rate is only for non-small cell lung cancer 15%, advanced non-small cell lung cancer (ⅢB or IV stage) 5-year survival rate of less than 2%. And intervention of traditional Chinese medicine makes many of the advanced patients maintain a better quality of life. In study on classification of syndrome of lung cancer, blood stasis and Qi deficiency and Yin deficiency have been reached some consensus, but at the moment of study on TCM syndrome of lung cancer in many clinical research methods doctors used different, lack of recognized, standardized, unified standards, repeatability less ideal, not widely used in clinical, is not conducive to the development of Chinese medicine in the diagnosis and treatment of lung cancer. This subjects in on related literature for analysis then selected has generalized phlegm card diagnosis standard, as into group standard. We observated 308 cases of advanced primary lung cancer to sum up some clinical characteristics and establish the discriminant points of advanced primary lung cancer:main symptoms. At the same time,the subject analysed the correlation between some common laboratory indicators and phlegm syndrome to provide a reference to the study of lung cancer.Research Objects:The subject observed 308 patients with advanced primary lung cancer who were in Oncology ward 11,15 and 19 of Guang'an men Hospital during 2009.11～2011.3. Each patient in the hospital the next day early morning on an empty stomach blood to laboratory investigation of blood routine and biochemical and tumor markers, and record the related symptoms in patients with signs.Research Methods:1. To draw up the initial subgroup standard:Because there is no uniform diagnostic criteria of phlegm, through the documents listed in the diagnostic criteria for finishing of phlegm, combined with the tutor for many years of clinical experience, selection of Fang Yongqi's generalized criteria of phlegm syndrome as the initial subgroup standard, divide into phlegm syndrome group and non-phlegm syndrome group; 2.Select the patients met the inclusion criteria, divide into phlegm syndrome group and non-phlegm syndrome group, as the observation of objects;3. Cleared up the phlegm symptoms and laboratory indicators involved in the literature and chose the higher frequency entries. After initial screening by experts,we observed 19 symptoms and 14 laboratory indicators. Symptoms:cough, expectoration, excessive phlegm, phlegm sound of throat, dizzy, chest tightness, asthma holding, shortness of breath, weak, poor appetite, nausea and vomiting, insomnia, deep sleep, obesity, painless and itch-free lump of cutis, visceral lump, fat tongue with tooth-trace, carex greasy, slip pulse. Laboratory indicators:WBC, PLT, NEUT%, HDL, APOA1, APOB, CHO, ALP, TG, LDH,CA199, CEA, CA153, CA125.4. Observed the basic situation of the sample:sex, age, the primary site, histopathology, surgery, clinical stage, KPS score, with lung infections, smoking history, family history of cancer.5.Statistical analysis:statistical analysis of the above observation project, came to the phlegm are associated with lung cancer; for clinical symptoms and signs, filter out lung cancer syndromes of phlegm distinguishing points determines its discrimination threshold; for laboratory indicators, analyze its significance in the diagnosis of lung phlegm.Results:1. Group of phlegm in sex, primary site, stage, KPS score, family history of cancer, with no statistically significant difference compared to non- phlegm syndrome group of. The phlegm syndrome group, more elderly patients. Phlegm syndrome group more squamous cell carcinoma and adenocarcinoma of the non- phlegm syndrome group more; for surgical cases, group is not more surgery of phlegm; groups with more people living with lung of phlegm, and non-statistically significant comparison of phlegm; phlegm syndrome group smoke longer than non-phlegm syndrome group.2. By clinical observation and statistical analysis, we established the syndromic discriminant points:Main symptoms:1. cough (17) 2. expectoration (12) 3. chest stuffy (12), second symptoms:1. excessive phlegm (10) 2. carex greasy (6) 3. painless and itch-free lump of cutis (5).Having the 3 main symptoms or 2 main symptoms plus 2 of second symptoms can form the diagnoses. By retrospective test, the sensitivity, specificity, accuracy and positive likelihood ratio was 90.24%,77.97%,83%,1.98%.3.In laboratory indicators, only LDH in phlegm syndrome group was lower than non-phlegm syndrome group, statistically with statistical difference.Conclusion: The phlegm in the research groups in sex, primary site, stage, KPS score, family history of cancer, with no statistically significant difference compared to non- phlegm syndrome group. Compared with non- phlegm syndrome group, group of older, more squamous cell carcinoma of phlegm, more no surgery, more complicated by lung infection, more smokers, tobacco age longer. Determine in the advanced lung cancer phlegm syndrome of quantitative diagnosis threshold value for 37, by clinical observation and statistical analysis, we established the syndromic discriminant points:Main symptoms:1. cough (17) 2. expectoration (12) 3. chest stuffy (12), second symptoms:1. excessive phlegm (10) 2. carex greasy (6) 3. painless and itch-free lump of cutis (5).Having the 3 main symptoms or 2 main symptoms plus 2 of second symptoms can form the diagnoses. In laboratory indicators, only LDH in phlegm syndrome group was lower than non- phlegm syndrome group, statistically with statistical difference.