摘要目的 观察同济大学附属上海肺科医院胸外科单中心手术治疗肺癌患者疾病谱的演变,探讨不同性别和地区患者组织学类型的分布差异和变化趋势.方法 回顾性分析1992年至2011年20年间在同济大学附属上海肺科医院胸外科行手术治疗的肺癌患者资料.分别统计患者性别、年龄、手术方式、TNM分期、户口所在地和病理类型,并在不同年份、性别和地区间进行比较.结果 手术治疗肺癌患者共12 117例,其中腺癌超过鳞癌成为最常见的类型,从1992年的30.43％上升至2011年的48.78％(P＜0.01),鳞癌从57.45％降至32.18％ (P＜0.01).男性鳞癌最多见,但从1992年的62.93％下降至2011年的44.78％ (P ＜0.01),腺癌从24.71％上升至34.44％(P＜0.01).女性腺癌最常见,且从1992年的53.97％持续上升至2011年的79.00％ (P ＜0.01).上海和上海周边地区患者分别以腺癌和鳞癌最为常见(P＜0.01).手术治疗的Ⅰ期非小细胞肺癌患者比例上升明显,从1992年的34.91％上升至2011年的53.25％(P＜0.01).结论 手术治疗的肺癌患者数量增长迅速,其组织学类型和非小细胞肺癌分期的分布已明显改变.

abstractsObjective To explore the distribution of histological types and pathological stages of lung cancer patients operated in Shanghai Pulmonary Hospital.Methods Data of patients with lung cancer who received surgical resection in thoracic surgery department of Shanghai Pulmonary Hospital from 1992 to 2011 were collected.Chi-square with the level of significance P ＜ 0.05 and chi-square test for trends were used as statistical methods.Results A number of 12 117 patients received surgical resection.Adenocarcinoma had become the most frequent histologic type among males and females combined,increased from 30.43％ in 1992 to 48.78％ in 2011,and squamous cell cancer decreased from 57.45％ to 32.18％.Squamous cell cancer was the most frequent histologic type in males but decreased from 62.93％ in 1992 to 44.78％ in 2011,followed by adenocarcinoma (increased from 24.71％ to 34.44％).Adenocarcinoma was the most frequent histologic type in females and increased from 53.97％ in 1992 to 79.00％ in 2011,followed by squamous cell cancer (decreased from 34.92％ to 5.6％).Adenocarcinoma and squamous cell cancer were the most frequent histologic type in patients from Shanghai and from aroud Shanghai separately.Patients with stage Ⅰ NSCLC had increased from 34.91％ in 1992 to 53.25％ in 2011.Conclusion The number of lung caner operated patients has increased quickly.The distribution of the histologic types and pathological stages of lung cancer operated patients has changed apparently.