2000年与2010年四川大学华西医院肺癌临床诊治特征的对比研究

BACKGROUND AND OBJECTIVE: Primary lung cancer is one of the most common malignant tumors. The aim of the current study is to retrospectively analyze the clinical features variation of patients with primary bronchogenic carcinoma in West China Hospital Sichuan University to provide information for early detection and treatment of lung cancer. METHODS: We collected data of patients of permanent population in Sichuan province who diagnosed primary bronchogenic carcinoma in 2000 and 2010 in West China Hospital Sichuan University respectively for comparative analysis of reasons to visit the doctor, duration from symptom onset to visit the doctor, combined diseases, incidences of bi-primary carcinoma, family history of malignant tumor, sites of tumors, grade of differentiation, tumor staging and initial treatment modalities. RESULTS: A total of 2, 167 cases (616 cases in 2000 and 1, 551 cases in 2010) met inclusion criteria were retrieved for analysis. In 2010, compared with data of 2000, the rate of patients who visit the doctors because abnormalities were detected by health examination elevated remarkably (5.2% vs 16.7%, P < 0.001), the duration from symptom onset to visit the doctor abridged significantly (P < 0.001), patients with family history of malignant tumor increased significantly (3.9% vs 13.7%, P < 0.001), the constituent ratio of poorly differentiated adenocarcinoma decreased (72.3% vs 51.8%, P=0.002) accompanied with low differentiated squamous cell carcinoma increased (59.4% vs 76.7%, P=0.002). For NSCLC staging, there is a notably increase of rate of stage Ⅰa (1.0% vs 4.5%, P < 0.001) and stage Ⅳ (30.4% vs 37.8%, P < 0.001) while decrease of stage Ⅲa (26.6% vs 14.8%, P=0.002). For initial treatment modalities, there is markedly increased chemotherapy rate of non-small cell lung cancer (NSCLC) patients (41.8% vs 63.4%, P=0.002) while remarkably increased surgery rate of stage Ⅲa patients (41.8% vs 63.4%, P=0.002) and decreased surgery rate of stage Ⅳ patients (9.4% vs 3.1%, P=0.001). The surgery rate of small cell lung cancer (SCLC) patients decrease sharply (30.4% vs 4.3%, P < 0.001). CONCLUSION: There clinical features of lung cancer patients were significantly changed in the past ten years, new prevention, diagnosis and treatment strategies are needed to accommodate the variation.