| Objective:This research analyzed the clinical characteristics and pathological types of patients with primary bronchogenic lung cancer in the past 5 years(2014-2018)of the Second Hospital of Lanzhou University by retrospective analysis,to initially understand the clinical characteristics and pathological changes of patients in recent years,and strengthen everyone's further understanding of lung cancer.Methods:A retrospective analysis of 2085 patients with primary lung cancer in the Second Hospital of Lanzhou University from 2014 to 2018 was collected.Data such as the patients'onset time,onset age,gender,geographical and urban-rural distribution,smoking history,pathological type,onset location,visiting clinical manifestations,diagnosis methods should be gathered.We used SPSS 23.0 statistical software to analyze the statistical results.P<0.05 indicated that the difference was statistically significant.Results:(1)A total of 2085 patients with primary lung cancer were collected from 2014 to 2018(repeated patients have been excluded),including 270 in 2014,349in 2015,383 in 2016,502 in 2017,and 581 in 2018.The number of newly diagnosed and newly treated lung cancer cases in our hospital is increasing year by year,and the number of male cases has always been higher than that of females.The total number of cases in 2018 was about 2.15 times that of 2014.(2)Adenocarcinoma(AD)has the highest proportion of 2085 cases of lung cancer(42.9%),followed by squamous cell carcinoma(SCC)(28.5%),small cell carcinoma(SCLC)(21.7%),adenosquamous carcinoma(ASC)(2.0%),and sarcomatoid carcinoma(SC)(1.6%),large cell carcinoma(LCC)(1.2%),other pathological types include adenoid cystic carcinoma,mucoepidermoid carcinoma,carcinoid,etc,accounting for 2.2%.The difference in the composition of lung cancer pathological types from 2014 to 2018 was statistically significant(?~2=40.31,P=0.020).(3)There were 1477 males and 608 females,with a male to female ratio of 2.43:1.SCC has the largest gender difference(8.90:1).Among male patients,SCC accounts for the highest proportion(36.2%);among female patients,AD accounts for the highest proportion(63.3%).(4)The maximum age is 93 years,the minimum age is 11 years,and the average age is 59.26±10.34years.No matter what pathological type,the age of the cases is concentrated between50-69 years(67.3%in total).The proportion of lung cancer in people under 39 and over 80 years old is low(total 4.8%).There was a statistically significant difference in the composition ratio of squamous cell carcinoma at different ages(?~2=39.94,P<0.001).(5)In the past 5 years,the proportion of lung cancer in rural areas increased and then decreased,but they were higher than those in urban areas.Among urban and rural lung cancer patients,the difference in the composition ratio of each pathological type was statistically significant(?~2=15.70,P=0.015).(6)About 53.9%of lung cancer patients have a history of smoking,including 1120 males and 4 females.There was a difference in smoking composition ratio between patients with different pathological types of lung cancer(?~2=335.1,P<0.001).SCC is the most common smoker patient,about 82.7%of SCC patients smoke,followed by LCC and SCLC,and the proportion of patients with AD smoking is the smallest(34.9%).(7)Lung cancer can occur in the trachea,main bronchus,individual lobe and any part of the pleura,and can involve one or more lobe.Right lung is more than left lung(?~2=36.31,P<0.001);upper lobe is more than lower lobe(?~2=21.96,P<0.001);left main bronchus is more than right main bronchus(?~2=28.74,P<0.001).The pathological types of lung cancer were different in different locations(P<0.001).About 12.6%of SCC occur in the trachea and bronchus,and the largest proportion(44.9%)in each pathological type.(8)The most common diagnosis is bronchoscopy or brush biopsy,which accounts for 60.6%,followed by surgical specimens(18.0%),percutaneous lung biopsy(8.6%),and pleural fluid exfoliation(3.7%).Approximately 11.2%of AD were diagnosed by percutaneous lung biopsy,significantly higher than those of SCC;about 6.8%of AD were diagnosed by pleural effusion cytology,and about 3.2%of AD were diagnosed by thoracoscopy pleural or lung biopsy,which was significantly higher than other pathological types.There were differences in the diagnosis methods of lung cancer in different years(?~2=95.67,P<0.001),and the proportion of diagnosis methods under bronchoscopy increased year by year.(9)Cough(68.3%),sputum(48.4%),chest tightness and shortness of breath(41.3%)were the main symptoms of lung cancer.About 24.4%of patients had wasting,and about 21.8%of patients had chest pain.Patients with different pathological types had different symptoms(P=0.001).SCC has a higher proportion of blood in sputum than other pathological types(41.5%of all pathological types);about 9.3%of AD are asymptomatic at the time of diagnosis and are mainly found through examination.(10)There are differences in the treatment of lung cancer in different pathological types(P<0.001).The proportion of patients who received surgery was 23.6%(493/2085),of which 12.0%(145/594)of SCC and27.1%(242/894)of AD,and the proportion of SCLC was 9.3%(42/452).SCC,AD,and SCLC are mainly treated with chemotherapy alone;targeted therapy is mostly used in AD,about 7.2%of patients with AD underwent targeted therapy,and approximately 0.6%of patients with AD underwent the combination therapy of surgery and targeting,1.0%of patients with AD were treated with chemotherapy combined with targeted drugs.Among 2085 patients with lung cancer,about 15.4%of patients received only symptomatic treatment,and about 15.6%refused treatment.Conclusion:(1)The number of newly diagnosed and newly diagnosed lung cancer cases from 2014 to 2018 in our hospital increased year by year,and male cases has always been higher than that of females.The proportion of SCC in all types of lung cancer has decreased year by year,while the proportion of AD has increased year by year.(2)AD accounts for the highest proportion,followed by SCC and SCLC.SCC is most common in male patients,followed by AD;female patients are mainly AD.(3)The age of lung cancer is concentrated in the age of 50-69,no matter what type of pathology;the number of cases in rural areas is higher than that in urban areas.(4)SCC has the largest smoking rate,followed by SCLC.(5)The most common diagnosis of lung cancer is bronchoscopy or brush biopsy,followed by surgical specimens and percutaneous lung biopsy.The proportion of lung cancer diagnosed through bronchoscopy has increased year by year,and it has now become the primary method for the diagnosis of lung cancer.(6)About 7.3%of asymptomatic patients were found through examination and 1/6 of lung cancer patients refused treatment,the health education and screening of lung cancer in Gansu should be strengthened to try for the early detection and treatment and reduce the burden of lung cancer disease. |
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