Comparison Of The Clinical Characteristics Of Lung Cancer In Young And Old Patients

Objective: To study the differences of the clinical cases characteristics ofyoung and elderly lung cancer patients, providing theoretical basis for theearly detection and diagnosis of young lung cancer.Methods:252patients with lung cancer in Hebei Medical UniversityFourth Hospital had been selected from January2009to December2009withthe method of retrospective analysis. All patients were diagnosed by pathology,including124young patients and128elderly patients. After checking data,119cases in each group were acceded to statistics and all patients wereaccepted initial treatment. The young group is defined for40years old or less,and the elderly group is defined for60years old or more[1-2]. We analyses thedata according to the following factors between two groups: gender, smokingstatus, family history of cancer, first symptoms, the other diseases of chestassociated, metastasis, pathology, the level of CEA, NSE, CA50, SCC beforetreatment, treatment methods. Rate and composition of enumeration dataincluding gender, smoking status, family history of cancer, first symptomswere compared by chi-square test. The level of CEA, NSE, CA50, SCC beforetreatment is measurement data, and described by mean±standard deviationcompared by non-parametric test. The median age of the young group was38years old, including56males and63females.16cases with pathologyundifferentiated,52patients with adenocarcinoma,10cases with squamouscarcinoma,36cases with small cell carcinoma,5cases with large cellcarcinoma. The median age of the elderly group was67years old, including83males and36females.21cases with pathology undifferentiated,55patientswith adenocarcinoma,27cases with squamous carcinoma,24cases with smallcell carcinoma,2cases with large cell carcinoma. To analysis the differencesof clinical factors between the two groups, in order to provide references for the early detection and diagnosis of lung cancer.Results:1Factors that had statistical differences:（1）Age: There were119cases in the young group, the median age was38years old (range19～40years old), occupying7.1%of lung cancer in thatyear. There were7case（s5.9%）in the range≤25years old,10cases（8.4%）in the range26-30years old,22cases （18.5%）in the range31-35years old,80cases（67.2%）in the range36-40years old. There were119cases in theelderly group, the median age was67years old (range60～88years old),occupying46.6%of lung cancer in that year. There were51cases（42.8%）inthe range60-65years old,39cases （32.8%）in the range66-70years old,16cases（13.4%）in the range71-75years old,11cases（9.2%）in the range76-80years old,2cases（1.7%）in the range≥80years old.（2）Gender: There were56males and63females in the young group,and83males and36females in the elderly group. The young group had morefemale, and had statistical differences（χ~2=12.608，P=0.000，P＜0.05）.（3）Smoking history: There were32cases（26.9%）that had smokinghistory in the young group, comparing with63cases（52.9%）in the elderlygroup. Difference was statistically significan（tχ~2=16.836，P=0.000，P＜0.05）.（4）Metastasis: The metastasis rate of lymph gland was7cases（5.9%）in the young group, comparing with25cases（21.0%）in the elderly group.Difference was statistically significant（χ~2=11.698，P=0.001，P＜0.05）.（5）Pathology: The main type of pathology in the young group wasadenoarcinoma（52/119，43.7%）, followed by small cell cancer（36/119，30.3%）. Adenoarcinoma（55/199，46.2%） also was the primary type of theelderly group, followed by squamous carcinoma（27/199，22.7%）. The ratioof squamous carcinoma in the elderly group was higher than that in the younggroup（χ~2=9.249，P=0.002，P＜0.05）.（6）The level of CEA、NSE、CA50、SCC before therapy: The CEA（64.11±165.41） of the young group tested by the immune particleluminescence method was higher than the elderly group, and difference was statistically significan（tZ=-2.017，P=0.044, P＜0.05）. The soluble cell keratingroup（13.35±18.38） of the elderly group tested by the same method washigher than the young group（7.74±15.27）, and difference was statisticallysignificant（Z=-2.953，P=0.003, P＜0.05）.（7）Therapy method: The ratios of operation+chemotherapy in theyoung group was higher than in the elderly group（χ~2=8.784，P=0.003，P＜0.05）.2Factors that had no statistical differences:（1）Family history of cancer: There were6（5%）cases that had familyhistory of cancer in the young group, comparing with13（10.9%） cases in theelderly group. Difference was not statistically significan（tχ~2=2.803，P=0.094，P＞0.05）.（2）The first symptoms: The first symptoms of the young group weremainly about cough and expectoration(43/119，36.1%）, followed by chestpain（18/119，15.1%）. The first symptoms of the elderly group also weremainly about cough and expectoration（44/119，37.0%）, followed by chokingsensation in chest, shortness of breath, and pant（22/119，18.6%）. Differenceof cough and expectoration（χ~2=0.018，P=0.893，P＞0.05）, chest pain（χ~2=1.924，P=0.169，P＞0.05）, and choking sensation in chest, shortness ofbreath, and pant （χ~2=0.767， P=0.381， P＞0.05） were not statisticallysignificant.（3）The other diseases of chest associated: The other diseases of chestassociated in the young and elderly groups both were pulmonary infection（2/119，1.7%;4/199，3.3%）, difference was not statistically significant.（χ~2=1.839，P=0.175，P＞0.05）。（4）Metastasis: There were78（65.5%）cases that happened metastasisin the young group, comparing with91（76.4%）cases in the elderly group. Themetastasis of both groups were mostly extrapulmonary（55/119，46.3%;56/119，47.1%）, the difference between the two groups was not statisticallysignificant（χ~2=0.017，P=0.897，P＞0.05）． （5）Therapy method: The main therapy method in the two groups werechemotherapy（53/119，44.5%;64/119，53.8%）, the difference was notstatistically significant（χ~2=2.034，P=0.154，P＞0.05）. The differences ofother therapy methods in the two groups were not statistically significant.Conclusions:（1）Factors that had statistical differences: The cases in theyoung group occupied7.1%of lung cancer in that year, and was the most inthe range36-40years old（67.2%）. The cases in the elderly group occupied46.6%of lung cancer in that year, and was the most in the range60-65yearsold（42.8%）. In the young group, female cases and the therapy method ofoperation+chemotherapy were more than that in the elderly group. The CEAof the young group tested by the immune particle luminescence method washigher than the elderly group. However, cases that had smoking history in theelderly group were more than that in the elderly group. Squamous carcinomaand lymph gland metastasis in the elderly group were more. The soluble cellkeratin group of the elderly group tested by the immune particle luminescencemethod was higher than the young group.（2）Factors that had no statistical differences: The differences of thefactors including family history of cancer, the first symptoms, the otherdiseases of chest associated, intrapulmonary and extrapulmonary metastasis,the level of CEA, NSE, CA50, CYFRA21-1tested by the immunoradiometricassay, the level of NSE, SCC tested by the immune particle luminescencemethod between two groups were not statistically significant.（3）The research suggested that young people especially the age from36to40should pay attention to regular physical examination even they werewithout any clinical symptoms. Facing with a young patient with smokinghistory, family history of cancer, cough and expectoration, or chest pain as themain clinical manifestations, we should be alert to the possibility of lungcancer.