Clinical Ananysis Of Chronic Obstructive Pulmonary Diseases Complicating Lung Cancer

Objective: COPD (chronic obstructive pulmonary diseases) have often concurrentwith lung cancer and they have common risk factors such as smoking, but whetherCOPD is an independent risk factor for lung cancer is uncertain. In order to make clearthe relationship between COPD and lung cancer,in this paper, the relevant cases and thecontrol group were collected for analysis.Methods: Patiens hospitalized in the first affiliated hospital of dalian medicaluniversity,from Nov.2008to Nov.2012are randomly selected.420cases diagnosed withprimary carcinoma of the trachea, bronchus and lung served as case group and473patients without any parts of cancer as control group,subjects complicated with COPDwould be maintained, patients merge with other lung benign disease (such as chronicbronchitis, emphysema, pneumonia, tuberculosis, etc.) of the research would beeliminated. logistic regression was used to explore the risk factors between them.Results:420cases and473controls were enrolled, cases are more likely to happenin males who were older than50years, compared with the controls,accounted for59.8%(controls45.7%). aged <50years old,50to59,60-69, and≥70years incases were10.2%(against17.8%),10.2%(compared to28.5%),26.0%(against23.3%),23.3%(compared to30.4%)respectively. Former and current smokers in cases(39.3%)were higher than controls (18.4%), never-smoking accounted for60.7%(cases) and81.6%(controls) respectively.The odds ratio of lung cancer in current and former smokers were3-4times thoseof never smokers (Odds ratio4.14, P <0.001),(Odds ratio2.61,P <0.001) respectively,after matched for age and gender,the effect still exist,odds ratio3.45(P=0.001）and2.77（P<0.001）respectively. On smoking status, lung cancer are more likely to happen inthe level2, the OR was2.43(P <0.001), there is still a statistically significant afteradjustment for age, gender, the OR was2.24(P <0.001). With a history of COPD (at least1year before the diagnosis of lung cancer) are more likely to increase the risk oflung cancer,comparing with the control group,the OR was3.85(P <0.001), whileafter adjustment for age, gender, smoking, smoking index, the OR was2.80(P=0.001).II, III+Ⅳgrades group compared with the normal lung function group, lung cancer ORwere4.91(P <0.001) and4.91(P=0.0038) respectively, but after adjusted the gender,age, smoking index. only class II have statistical significance, ORawas3.82(P=0.002).In smoking case group,the history of COPD increase the risk of squamous carcinomacompared with other descaling non-small cell carcinoma,the OR was5.78(P <0.001),after adjusyed the age, sex, smoking index, there are still statistically significant, the ORwas4.99(P=0.002).47cases of COPD complicated lung cancer, age from50to80years, the medianage was (70.0±7.28), predominantly male (74.47%), the main symptoms were:cough, expectoration(33cases), haemoptysis (8cases), chest tightness(18cases),difficulty breathing and chest pain (5cases), voice hoarse (3cases), fever(5cases),pulmonary neoplasm (10cases), progressive emaciation(4cases). Imaging findings as:45cases were examined by CT, main show is in irregular mass shadow lungs, lobulatedburr, pleural retraction, mediastinal lymph node enlargement, etc.Conclusion:1.COPD is the independent risk factor for lung cancer, the risk is notconfused by smoking index, age, gender etc.2.COPD are more likely to complicatewith the squamous cell histological subtype, especially the later period.3.Patients with ahistory of COPD maybe served as the early lung cancer screening people.