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背景与目的青年(年龄≤40岁)非小细胞肺癌(non-small cell lung cancer,NSCLC)发病率呈上升趋势。本研究旨在分析青年NSCLC的临床病理生理特征、治疗及预后情况。方法对102例资料完整的青年NSCLC患者进行回顾性分析。结果女性所占比例为43.1%,男女比例为1.32:1;29.4%有吸烟史;以腺癌为主,占77.5%;以低分化癌为主,占64.1%;晚期肺癌(Ⅲb期及IV期)占87.8%。6例接受手术治疗患者的中位复发时间为13.5个月。87例接受一线化疗患者的客观有效率(objective responserate,ORR)为46.0%,疾控率(disease controled rate,DCR)为79.3%,中位肿瘤进展时间(time to progress,TTP)为5.0个月。38例接受表皮生长因子受体酪氨酸激酶抑制剂(epidermal growth factor receptor-tyrosine kinase inhibitors,EGFR-TKI)治疗患者ORR为40%,DCR为65.7%,中位TTP为5.5个月;12例二次或多次TKI治疗患者DCR为66.7%,中位TTP为3.0个月。结论青年NSCLC中位确诊时间长,女性所占比例相对较高,与吸烟的相关性较弱,以分化差的晚期腺癌为主,确诊后应给予积极的综合治疗,但总体预后不佳。
Background and Objectives The incidence of non-small cell lung cancer (NSCLC) in young (age ≤40 years) patients is on the rise. This study aimed to analyze the clinical pathophysiological characteristics, treatment and prognosis of young NSCLC. Methods A total of 102 cases of NSCLC with complete data were retrospectively analyzed. Results The proportion of women was 43.1%, male to female ratio was 1.32: 1; 29.4% had smoking history; adenocarcinoma was the major component, accounting for 77.5%; poorly differentiated cancer was the major component, accounting for 64.1%; advanced lung cancer (Ⅲb and IV Period) accounted for 87.8%. The median time to recurrence in 6 patients who underwent surgery was 13.5 months. The objective response rate (ORR) of 87 patients receiving first-line chemotherapy was 46.0%, the disease congenital rate (DCR) was 79.3%, and the median time to progress (TTP) was 5.0 months . Among the 38 patients who received epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), the ORR was 40%, the DCR was 65.7% and the median TTP was 5.5 months. In 12 cases Patients with two or more TKIs had a DCR of 66.7% and a median TTP of 3.0 months. Conclusion The median diagnosis time of NSCLC is young, the proportion of women is relatively high, and the correlation with smoking is weak. The poorly differentiated advanced adenocarcinoma is the mainstay. Positive comprehensive treatment should be given after diagnosis, but the overall prognosis is poor.