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投稿时间：2022-01-06 网络发布日期：2022-03-20
投稿时间：2022-01-06 网络发布日期：2022-03-20
中文摘要: 目的 探讨肺癌患者不同肺功能受损程度与肿瘤影像学分布的关系及其影响因素，以便临床早期诊断及评估肺癌患者的预后。 方法 对2018年8月至2021年1月在江苏省中医院经过住院治疗的108例肺癌患者的一般资料及影像资料进行回顾性分析，其中包括肺功能、性别、年龄、吸烟指数、肿瘤影像学指标、病理类型及肿瘤分期，依据肺功能水平将肺癌患者分为对照组（n=57）、保存率肺功能受损（PRISm）组（n=17）及慢性阻塞性肺疾病（COPD）组(n=34)。 结果 和对照组相比，PRISm组及COPD组男性发病率更高，发病年龄更大，吸烟指数>20的占比人数更多，差异均有统计学意义（P<0.01）；三组研究对象BMI差异无统计学意义（P>0.05）；和对照组相比，PRISm组及COPD组肺功能指标FEV 1 、FEV 1 /FVC比值及FVC均较低，中央型鳞癌更多，肿瘤体积也更大，差异有统计学意义（P<0.01）；对照组肺癌多位于Ⅰ期（78.9%），而PRISm组和COPD组肺癌多位于Ⅳ期（41.2%、44.1%）。 结论 PRISm和COPD同属于肺功能受损范畴，两者合并肺癌时好发于老年男性吸烟患者，中央型鳞癌发生率高，早期临床表现缺乏特异性，首次确诊时分期较晚，定期对PRISm和COPD患者行胸部高分辨率CT（HRCT）可以尽早发现肺癌，提高患者预后。
Abstract:Objective To investigate the relationship between different degrees of pulmonary function impairment and tumor imaging distribution in patients with lung cancer and its influencing factors, so as to make early clinical diagnosis and evaluate the prognosis of patients with lung cancer. Methods The general data and imaging data of 108 lung cancer patients hospitalized in Jiangsu Province Hospital of Chinese Medicine from August 2018 to January 2021 were retrospectively analyzed, including lung function, gender, age, smoking index, tumor imaging indexes, pathological type and tumor stage. According to the level of lung function, patients were divided into control group (n=57), preserved ratio impaired lung function (PRISm) group (n=17) and chronic obstructive pulmonary disease (COPD) group (n=34). Results Compared with the control group, the incidence rate of male and PRISm group and COPD group were higher, the age of onset was bigger, and the proportion of smoking index>20 was more than that of the control group (P<0.01). There was no significant difference in BMI among the three groups (P>0.05). Compared with the control group, the pulmonary function indexes, induding FEV 1 , FEV 1 / FVC ratio and FVC, in PRISm group and COPD group were lower (P<0.01). Compared with the control group, there were more central squamous cell carcinomas and larger tumor volume in PRISm group and COPD group (P<0.01). Lung cancer in the control group was mostly in stage Ⅰ (78.9%), while lung cancer in PRISm group and COPD group was mostly in stage Ⅳ (41.2% and 44.1%). Conclusion PRISm and COPD belong to the category of impaired lung function. When they are combined with lung cancer, they tend to occur in elderly male smokers. The incidence of central squamous cell carcinoma is high, the early clinical manifestations are lack of specificity, and the stage is late at the first diagnosis. Regular chest high resolution CT in patients with PRISm and COPD can detect lung cancer as early as possible and improve the prognosis of patients.
keywords: Preserved ratio impaired spirometry Lung cancer Chronic obstructive pulmonary disease High resolution CT Pulmonary function
文章编号： 中图分类号：R734.2 文献标志码：A
基金项目:国家自然科学基金（81973005）
| 作者 | 单位 |
| 朱丽1 | 1. 南京中医药大学附属医院放射科，江苏 南京 210000 |
| 刘佳莉2 | 2. 东南大学公共卫生学院，江苏 南京 210000 |
| 曾亮1 | 1. 南京中医药大学附属医院放射科，江苏 南京 210000 |
| 向全永2,3 | 2. 东南大学公共卫生学院，江苏 南京 210000； 3. 江苏省疾病预防控制中心慢性非传染性疾病控制科，江苏 南京 210000 |
| Author Name | Affiliation |
| ZHU Li*, LIU Jia-li, ZENG Liang, XIANG Quan-yong | * Department of Radiology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210000, China |
引用文本：
朱丽,刘佳莉,曾亮,等.肺癌患者不同肺功能受损程度与肿瘤影像学分布的关系[J].中国临床研究,2022,35(3):339-342.
朱丽,刘佳莉,曾亮,等.肺癌患者不同肺功能受损程度与肿瘤影像学分布的关系[J].中国临床研究,2022,35(3):339-342.