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目的:探讨不同病理类型IV期原发性支气管肺癌的远处转移特点。方法:回顾性分析我科收治的622例诊断明确、资料完整的IV期肺癌患者,比较不同病理类型肺癌患者各器官远处转移发生率,并进行统计学分析。结果:622例IV期肺癌患者中,鳞状细胞癌188例(30.2%),腺癌275例(44.2%),小细胞癌130例(20.9%),大细胞癌5例(0.8%),腺鳞癌14例(2.3%)。平均年龄55.4岁,男女比例为2.60:1,高发年龄为40~60岁。各器官远处转移发生率从高到低依次为:骨267例(42.9%),胸膜212例(34.1%),双肺162例(26.0%),脑148例(23.8%),肝132例(21.2%),肾上腺53例(8.5%),心包50例(8.0%),皮下转移6例(1.0%),肌肉3例(0.5%),眼球和脊髓各1例(0.2%)。单器官转移共283例(45.5%),多器官转移共339例(54.5%),最多为6个器官远处转移。结论:不同病理类型肺癌有各自不同的远处转移特点及临床特征,应选择相应的检查并制定针对性治疗方案。
Objective: To investigate the distant metastasis characteristics of stage IV primary bronchogenic carcinoma with different pathological types. Methods: A retrospective analysis of our 622 cases of patients with well-diagnosed, complete data of stage IV lung cancer patients, comparison of different pathological types of lung cancer patients with distant metastasis incidence and statistical analysis. Results: Of the 622 patients with stage IV lung cancer, 188 (30.2%) had squamous cell carcinoma, 275 (44.2%) had adenocarcinoma, 130 (20.9%) had small cell carcinoma and 5 (0.8% Adenosquamous carcinoma in 14 cases (2.3%). The average age of 55.4 years old, male to female ratio of 2.60: 1, high incidence of 40 to 60 years old. The rates of distant metastasis of organs were 267 (42.9%), 212 (34.1%), 162 (26.0%), 148 (23.8%) and 132 (21.2%), adrenal gland in 53 (8.5%), pericardial in 50 (8.0%), subcutaneous metastasis in 6 (1.0%), muscle in 3 (0.5%) and eye and spinal cord in 1 (0.2%). A total of 283 cases (45.5%) of single organ metastases, 339 cases (54.5%) of multiple organ metastases, up to 6 organs distant metastasis. Conclusion: Different pathological types of lung cancer have their own characteristics of different distant metastases and clinical features, and should select the appropriate test and develop targeted treatment options.