Analysis Of Clinical And Pathological Characteristics In 215 Young People With Lung Cancer

[Objective]Analyze the clinical manifestations,pathological features and prognosis of young people with lung cancer,provide reference for the diagnosis and individualized treatment of lung cancer in young people,and reduce misdiagnosis.[Methods]A retrospective analysis was used to collect 215 young people aged less than 40 years old and diagnosed as primary bronchogenic carcinoma from January 1,2000 to December 30,2013 of the Affiliated Cancer Hospital of Guangxi Medical University.Retrospective method is used for the examination of cases.The above cases have clear histological types and tumor stages.The information is complete and the diagnosis and treatment process is detailed.To collect and record all patients' sex,age,smoking history,family history of tumor,occupation,first symptom,tumor location,tumor size,lymph node metastasis,distant metastasis,serum CEA pleural invasion,misdiagnosis rate,diagnosis time,diagnosis method,pathological type,tumor differentiation,TNM staging,and treatment methods.And comparative analysis.[results]The incidence of lung cancer in young men was 54.9%(118/215),female 45.1%(97/215),and the ratio of men and women was 1.22:1.The age range was 14~40 years old and the median age was 34.5 years old.Among them,35 year old lung cancer patients accounted for 59.5%(128/215).The incidence of 14-40 years old increased gradually with age.Smoking among young patients with lung cancer was smoking.History accounted for 27%(58/215),and all were male.The clinical symptoms of lung cancer patients were not distinct,cough,expectoration,44.7%(96/215),followed by chest tightness and 14%(30/215);the duration of the symptoms was long,the maximum of 1~3 months was 47.4%(102/215),the average duration was 3.6 months,and the rate of misdiagnosis was 36.7%(79/2 15),among them,they were misdiagnosed as pneumonia 45.6%(36/215)and tuberculosis 40.5%(32/215);the pathological type of adenocarcinoma was 58.1%(125/215),low differentiated tumor 53.6%,the tumor located in the right lung 58.1%(122/215),and the tumor size was 80.5%(173/215).Late tumor(IIIB~IV)85.6%(184/215),with a clear diagnosis of distant metastasis 48.8%(105/215),including 37 cases of pulmonary metastases(34.9%),33 cases of bone metastases(31.2%).The surgical resection rate was 11.2 %.The survival time of the young patients with lung cancer was 1~84 months and the median survival time was 15.1 months.The 1,2,and 3 year total survival rate(OS)were 49.8%,22.2% and 11.5% respectively.Kaplan--Meier single factor analysis showed that smoking history(P=0.048),misdiagnosed disease(P=0.036),lymphnodemetastasis(P=0.000),distantmetastasis(P=0.000),pat-hologicaltype(P=0.000),TNMstaging(P=0.000)andtreatmentmethods(P=0.000)were factors affecting the prognosis of lung cancer in young people.COX multivariate regression analysis showed that distant metastasis(P=0.010),pathologicaltype(P=0.012),TNMstaging(P=0.000)andtreatmentmethods(P=0.000)were independent factors affecting the prognosis of lung cancer in young people.[Conclusion]The overall incidence of lung cancer in young people is not high,but the incidence of lung cancer in young women has increased.The clinical manifestations are still the most common in cough and sputum,and the symptoms last longer;CT showed large nodules and mass shadow,high misdiagnosis rate,common adenocarcinoma,low differentiation,high malignancy,strong invasion,and most of the tumor in the middle and late stages of the tumor(IIIB~IV).The resection rate is low and the prognosis is poor.