Objectives: Lung cancer is characterized by its high incidence and case fatality rate. Factors related to population composition and cancer prevention programme policy have an effect on the incidence and diagnosis of lung cancer. This study aims to provide scientific support for early diagnosis and treatment of lung cancer by investigating the clinic information, pathological, and imaging characteristics of surgical patients with lung cancer.
Methods: The data of 2 058 patients, who underwent surgery for lung cancer in the Department of Thoracic Surgery of Xiangya Hospital of Central South University from 2016 to 2019, were retrospectively collected to analyze changes in clinic information, pathological, and imaging characteristics.
Results: From 2016 to 2019, the number of patients per year was 280, 376, 524, and 878, respectively. Adenocarcinoma (68.1%) was the most common pathological type of surgical patients with lung cancer. From 2016 to 2019, the proportion of adenocarcinoma was increased from 55.5% to 74.1%. The proportion lung cancer patients in stage IA was increased from 38.9% to 62.3%, and the proportion of patients who underwent sublobar resection was increased from 1.8% to 8.6%. The proportion of lymph node sampling was increased in 2019. Compared with the rate in 2016, the detection rate of nodules with diameter≤1 cm detected by CT before surgery in 2019 was significantly improved (2.0% vs 18.2%), and the detection rate of nodules with diameter>3 cm was decreased (34.7% vs 18.3%). From 2016 to 2019, the proportion of lesions with pure ground-glass density and partial solid density detected by CT was increased from 2.0% and 16.6% to 20.0% and 37.3%, respectively. The proportion of solid density was decreased from 81.4% to 42.7%.
Conclusions: The number of lung cancer surgery patients is rapidly increasing year by year, the proportion of CT-detected purely ground-glass density and partially solid density lesions are increasing, the proportion of patients with adenocarcinoma is rising, the proportion of early-stage lung cancer is increasing, smaller lung cancers are detected in earlier clinical stage leading to a more minimally invasive approach to the surgical methods.
目的: 肺癌的发病率和病死率高、生存率低，与癌症预防政策和人口构成相关的因素会影响癌症的发病率和诊疗方式。本研究旨在分析肺癌手术患者的临床信息、病理及影像特征，以期为肺癌的早期诊疗提供依据。方法: 回顾性收集2016年至2019年在中南大学湘雅医院胸外科进行肺癌手术的2 058例患者的临床资料，分析患者临床信息、病理及影像学特征的变化。结果: 从2016年到2019年，每年患者数分别为280、376、524和878例；腺癌是最常见(68.1%)的病理类型，占比从2016年的55.5%增加至2019年的74.1%；ⅠA期肺癌占比从2016年的38.9%上升至2019年的62.3%；亚肺叶切除手术占比由2016年的1.8%增加至2019年的8.6%。2019年的淋巴结采样比例增加。与2016年相比，2019年术前CT发现的直径≤1 cm的结节发现率明显提高(2.0% vs 18.2%)，直径>3 cm的肿块发现率降低(34.7% vs 18.3%)；CT表现为纯磨玻璃密度及部分实性密度的病变比例由2.0%和16.6%上升至20.0%和37.3%，实性密度比例由81.4%下降至42.7%。结论: 肺癌手术患者数量逐年增加，CT发现的纯磨玻璃密度及部分实性密度病变的比例增高，腺癌患者比例逐年上升，早期肺癌的比例越来越高，发现的肺癌更小、临床分期更早，从而使手术方式更趋向于微创。.
Keywords: lung cancer; pathological types; pulmonary nodules; radiology.