| Objective: To investigate the biological characteristics, clinical features, survival status and prognostic factors of female lung cancer.Methods: A retrospective analysis of clinical data of 237 cases of female lung cancer in the First Affiliated Hospital of Soochow University from December 2010 to 2013December; And the prognosis of the patients were followed up by telephone. Using statistical methods to analyze the clinical features, survival status and prognostic factors of the patients, Wilcoxon rank sum test was used in the serum tumor markers;Kaplan- Meier method was used to analyse the single factor and then Log-rank inspection; COX model was used to analyse the multiariate factors.Results: 237 cases of female lung cancer patients ranged in age from 23 to 79 years old,an average of 57.2 ± 10.2 years old,and a median age of 58 years old. The peak age of onset was 40 to 69 years old,accounting for 85.7%;78.9%(187/237) of the patients showed the first symptoms and cough and expectoration were the main performance(45.6%, 108/187); Asymptomatic cases(21.1%, 50/237) were found in physical examination; Right lung cancer was slightly more than left lung(58.2% VS 39.7%), with the surrounding type(63.7%, 151/237) as the main; 84.8%(201/237) patients could be diagnosed within 3 months, mainly relying on open chest, chest surgery(32.9%, 78/237)and bronchoscopy(30%, 71/237);The positive rate of bronchoscopy was 79.3%(73/92);The proportion of positive rate in bronchoscopy biopsy was 69.6%(64/92),and 33.7%(31/92) in bronchoscopy brush check;The pathologic types of female lung cancer were mainly adenocarcinoma(65.4%, 155/237);IIIB-IV stage lung cancer accounted for 64.6%(153/237);50 cases of lung cancer were found in physical examination accounting for21.1%(50/237),among which the IA-IIIA stage accounted for 70.0%(35/50);CEA,CA125,CYFRA21-1,NSE in advanced lung cancer had increased than in the early, middlestage and the difference was statistically significant( P<0.05); EGFR sensitive mutation(exon 19 LREA deletion and exon 21 L858 R mutation) accounted for 60.3%(35/58) in 58 cases patients with EGFR gene mutation status clearly;28.3%(67/237) of the patients had been diagnosed with distant organ metastases, with bone metastases(70.1%, 47/67) and brain metastases(29.9%, 20/67) as the main;Surgical treatment was performed in 93 of the patients,accounting for 39.2%(93/237);213 patients received chemotherapy(including preoperative and postoperative) accounting for 89.9%(213/237);111 patients received EGFR tyrosine kinase inhibitors(EGFR-TKI) therapy accounting for 46.8%(111/237);The survival time of female lung cancer was 0.2 months to 142 months and the median overall survival time was 24 months;1-year accumulate survival rate were 54% and 5-year cumulative survival rates for 13%;EGFR gene mutations in patients with targeted therapy could benefit from progression free survival comparing with wild-type EGFR in patients with chemotherapy(12.5 months vs 7.1 months, P < 0.01), but overall survival no difference(24.1 months vs 22.2 months. P=0.64). Kaplan Meier survival analysis indicated that tumor TNM stage at diagnosis, adenocarcinoma differentiation, the first symptoms,serum CEA level, surgical treatment,distant organ metastasis at diagnosis and anti tumor treatment of seven variables were related with prognosis;In addition, chemotherapy was a prognostic factor for advanced female lung cancer; Multivariate analysis showed that tumor TNM stage at diagnosis, the first symptom, surgical treatment, distant organ metastasis at diagnosis and anti tumor treatment were the independent factors influencing the prognosis.Conclusion:1.Female lung cancer incidence peak age was 40-69 years old, with cough and expectoration, chest tightness, shortness of breath and other nonspecific respiratory symptoms.2.The pathological type of female lung cancer was mainly adenocarcinoma, with the majority of the peripheral type. With early metastasis, bone and brain were the most common metastatic sites and the majority of patients were diagnosed with loss of surgical opportunity. But the patients who found in physical examination were mainly in IA-IIIA stage.3.The level of serum tumor markers(CEA, CA125, CYFRA211, NSE) were related tothe stage of female lung adenocarcinoma tumor.4.In this group of data, the mutation rate of EGFR gene in female lung cancer patients was 60.3% and the EGFR gene mutations patients could benefit from targeted therapy in PFS. The median overall survival time of female lung cancer was 24 months.Tumor TNM stage at diagnosis, adenocarcinoma differentiation, the first symptoms, serum CEA level, surgical treatment, distant organ metastasis at diagnosis and anti tumor treatment were related with prognosis. Chemotherapy was a prognostic factor for advanced female lung cancer. Tumor TNM stage at diagnosis, the first symptom, surgical treatment,distant organ metastasis at diagnosis and anti tumor treatment were the independent factors influencing the prognosis.5.Women at high risk of age who had physical examinations regularly could be found lung cancer in the early stage, so as to obtain more surgical treatment opportunities. |
PDF Full Text Request