■虽然支气管肺癌的检查和治疗,也称为肺癌(LC),变得更加有效和精确,LC的发病率和死亡率在全球范围内仍然很高。描述LC特性随时间变化的轮廓是不可缺少的。本研究旨在了解中国LC的现实环境变化及其特点。
■在这项研究中,2012年至2020年,上海市肺科医院纳入119,785例患者。患者的医疗记录是从医院的数据库中提取的。人口特征,一般临床病理信息,最初诊断时的凝血指标使用Kruskal-Wallis进行分析,尼门尼,卡方,和Bonferroni测试。8年研究期间人口统计学特征的变化,即不同阶段和不同病理类型之间的动态变化,进行了评估。
■在研究期间,女性(从2012年的38.50%[323/839]到2020年的48.29%[5112/10,585])和非吸烟LC(从69.34%[475/685]到80.48%[8055/10,009])患者的百分比显着增加,诊断时年龄趋于年轻(从3.58%[30/839]到8.99%[952/10,585])。在学习期间,肺腺癌的比例和绝对数量增加(从67.97%[433/637]增加到76.31%[6606/8657]),而肺鳞癌的比例减少(从21.19%[135/637]减少到12.08%[1046/8657])。全面的驾驶员基因突变检查变得越来越普遍,和表皮生长因子受体(EGFR)突变更频繁地发生在女性和男性(62.03%[12793/20625]vs.29.90%[8207/27,447])和非吸烟vs.吸烟(53.54%[17,203/32,134]vs.23.73%[3322/13,997])患者(均P<0.001)。在LC的不同阶段,常见驱动基因的分布有所不同。EGFR突变在每个阶段最常见,其他驱动基因改变在晚期阶段更为常见(P<0.001)。联合化疗,靶向治疗,和免疫疗法,作为一个全面的管理方案,在研究期间逐渐占优势(P<0.001)。晚期LC患者和间变性淋巴瘤激酶融合患者出现高凝状态,D-二聚体水平显著升高,纤维蛋白原,和纤维蛋白原降解产物。
■这项研究全面描述了中国LC患者在8年期间的变化特征,以提供对LC治疗的初步见解。试用注册:ClinicalTrials.gov,NCT05423236。
UNASSIGNED: Although examinations and therapies for bronchial lung cancer, also called lung cancer (LC), have become more effective and precise, the morbidity and mortality of LC remain high worldwide. Describing the changing profile of LC characteristics over time is indispensable. This
study aimed to understand the changes in real-world settings of LC and its characteristics in China.
UNASSIGNED: In this
study, 119,785 patients were enrolled from 2012 to 2020 in the Shanghai Pulmonary Hospital. The patients\' medical records were extracted from the hospital\'s database. Demographic characteristics, general clinicopathological information, and blood coagulation indices at the initial diagnoses were analyzed using the Kruskal-Wallis, Nemenyi, chi-squared, and Bonferroni tests. Changes in demographic characteristics during the 8-year
study period, namely dynamic changes among different stages and different pathological types, were evaluated.
UNASSIGNED: The percentages of female (from 38.50% [323/839] in 2012 to 48.29% [5112/10,585] in 2020) and non-smoking LC (from 69.34% [475/685] to 80.48% [8055/10,009]) patients increased significantly during the study period, with a trend toward a younger age at diagnosis (from 3.58% [30/839] to 8.99% [952/10,585]). Over the
study period, the proportion and absolute number of lung adenocarcinoma cases increased (from 67.97% [433/637] to 76.31% [6606/8657]) while the proportion of lung squamous cell carcinoma decreased (from 21.19% [135/637] to 12.08% [1046/8657]). Comprehensive driver gene mutation examination became more common, and epidermal growth factor receptor (EGFR) mutation occurred more frequently in female vs. male (62.03% [12793/20625] vs. 29.90% [8207/27,447]) and non-smoking vs. smoking (53.54% [17,203/32,134] vs. 23.73% [3322/13,997]) patients (both P < 0.001). The distribution of the common driver genes differed among different stages of LC. EGFR mutation was detected most frequently at each stage, and other driver gene alterations were more common in advanced stages (P <0.001). The combination of chemotherapy, targeted therapy, and immunotherapy, as a comprehensive management regimen, gradually became predominant over the study period (P < 0.001). A hypercoagulable state was shown in advanced-stage LC patients and patients with the anaplastic lymphoma kinase fusion, indicated by significantly elevated levels of d-dimer, fibrinogen, and fibrinogen degradation products.
UNASSIGNED: This
study comprehensively depicted the changing characteristics of Chinese LC patients over an 8-year period to provide preliminary insights into LC treatment.Trial registration: ClinicalTrials.gov, NCT05423236.