비흡연가 폐암의 임상상
Clinical Features of Advanced Non-Small Cell Lung Cancer in Never-Smokers
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목적: 본 연구는 비흡연가에서의 진행성 폐암의 임상적 특성에 대해 알고 이를 토대로 적절한 치료 방향 설정하기 위함에 있다방법: 본원에서 진단된 폐암환자들을 대상으로 의무기록을 통해 105명의 비흡연자를 선별하였으며 수술 가능한 병기의 환자를 제외하고 stage III, IV의 진행 병기 환자를 대상으로 성별, 나이, 신체활동도와 종양 표지자 수치, 생존 기간 등에 대해 조사하였으며 EGFR-TKI 치료반응성에 대해 알아보았다 . 결과: 전체 비흡연가 중 여성이 많았고, 조직형상 선암이 많았으며 생존기간의 중앙값은 19.2개월이었으며 여성, 선암, 저연령층, NSE 값이 15이하인 환자들에서 생존기간이 길었다. 또한 EGFR-TKI로 치료받은 군에서 생존기간이 길었으며 관해 지속기간 역시 길게 나타났다. 결론: 비흡연가에서의 폐암 임상상에 대해 알아보았으며 향후 흡연가에서의 임상상과 비교를 통해 비흡연가에 적절한 치료에 대해 연구되어야 한다.
Abstract
Background/Aims:Smoking is major cause of lung cancer. However, the prevalence of lung cancer in never-smokers increasing recently. This study investigated the clinical characteristics of advanced lung cancer in never-smokers. Methods:We anlyzed the clinical characteristics including demographics, bronchoscopic features, stage, and serum tumor markers, of never smokers with lung cancer seen at Kosin University Hospital from January 2001 to December 2008. Results:There were 105 never smokers with lung cancer (mean age 61 years, 82 females), comprising 83 (79%) adenocarcinomas, 9 (8.6%) squamous carcinomas, and 13 (12.4%) undifferenciated carcinomas. The overall median survival time (MST) was 18.7 months. The MST was longer in females (21.6 vs. 13.7 months, p = 0.03), patients younger than 60 years (19.2 vs. 17.5 , p = 0.019), and those with adenocarcinoma (21.6 vs. 8.8 months, p = 0.038), and a neuron-specific enolase level of less than 15 ng/mL (22.4 vs. 13.4 months, p = 0.014). Conclusions:We analyzed the clinical characteristics of advanced lung cancer in never smokers. A more comprehensive study is need to compare never-smokers and smokers with lung cancer and to determine the appropriate treatment for non-smokers. (Korean J Med 2011;80:427-433)
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