【摘要】 目的　探讨 <4 0岁青年人肺癌的临床病理特征及预后 ,并与≥ 4 0岁的中老年人肺癌进行比较。方法　对 12 9例青年人肺癌 (青年组 )以及随机选择的 14 0例中老年人肺癌 (中老年组 )进行回顾性分析 ,比较两组临床病理特征和生存期。结果　青年组与中老年组相比 ,青年组女性患者比例高 (P =0 .0 37) ,平均症状持续时间长 (4 .7个月 ,P <0 .0 0 1) ,误诊率高 (6 5 .1% ,P <0 .0 0 1) ,平均误诊时间长 (5 .6个月 ,P <0 .0 0 1) ,以腺癌为主要病理类型 (5 4 .3% ,P <0 .0 0 1) ,癌细胞分化差 (6 9.5 % ,P <0 .0 0 1) ,诊断时晚期多 (74 .4 % ,P <0 .0 0 1) ,接受综合治疗的比例高 (94 .6 % ,P <0 .0 0 1) ,因远处转移而致治疗失败者的比例高 (6 4 .7% ,P =0 .0 2 )。两组总的中位生存期和 5年生存率差异无显著性 (P =0 .2 889) ,但Ⅰ期和Ⅱ期中 ,青年组中位生存期及 5年生存率优于中老年组 (P =0 .0 4 95 )。两组肿瘤家族史及吸烟史差异无显著性。结论　青年人肺癌的临床病理特征明显不同于中老年人肺癌 ,但生存期相似。将青年人肺癌定义为“青年型肺癌”有临床实际意义。更多还原

【Abstract】 Objective To study whether the clinico pothologic characteristics and survival of young lung cancer patients <40 years of age differ from those of lung cancer patients ≥40 years of age. Methods Retrospective analysis was carried out to compare the clinico pathologic features and survival of 129 young patients (young group) with those of 140 randomly selected older ones (elderly group). Results The young group, when compared with the older group, had more female ( P =0.037), longer mean duration of symptoms (4.7m vs 2.5m , P < 0.001 ), higher misdiagnostic rate (65.1% vs 24.3%, P <0.001) with longer mean duration of misdiagnosis for the misdiagnosed patients (5.6m vs 2.5m, P <0.001), more adenocarcinoma (54.3% vs 42.1% , P < 0.001 ), higher pathologic grade (69.5% vs 36.0%, P <0.001), more advanced stage diseases at diagnosis ( 74.4% vs 45.7%, P < 0.001 ), more patients receiving combined modality treatment (94.6% vs 62.1%, P < 0.001 ) and more distant failures as initial relapse (64.7% vs 50.6%, P =0.02). The median survivals and 5 year survival rates were better in patients with stage Ⅰ Ⅱ disease in the young group than the older group (54m vs 33m and 46.2% vs 25.0%, P =0.049 5), even though the overall median survivals and 5 year survival rates were similar in either group (11m vs 14m and 8.3% vs 11.9%, P =0.288 9). There was no difference in family or smoking history ( P =0.227 and 0.171). Conclusion Younger patients with lung cancer present difference in clinico pathologic features from the older ones, but the survivals of the two groups are similar. To define younger lung cancer as "the younger type of lung cancer" may have a practical clinical significance.更多还原