影响恶性肿瘤诊治的非肿瘤性疾病分析

Abstract

目的:了解恶性肿瘤患者合并的非肿瘤性疾病情况,探讨非肿瘤性疾病对肿瘤患者诊疗方案的影响.方法:收集2013年1月1日至2017年12月31日北京大学肿瘤医院住院患者经院际会诊的1323例病历资料,筛选其中合并非肿瘤性疾病的病例.回顾性分析该组患者的临床病历资料,探讨非肿瘤性疾病在肿瘤诊治过程中的影响.结果:本研究1323例院际会诊病例中,筛选出非肿瘤性疾病1153例(87.2％),其中男性773例(67.0％),女性380例(33.0％).年龄为14～90岁,中位年龄62岁.原发肿瘤类型包括:肺癌、胃癌、淋巴瘤、结直肠癌、食管癌、乳腺癌、恶性黑色素瘤、肝癌、胆管癌/胆囊癌、胰腺癌和其他肿瘤.非肿瘤性疾病情况为心血管疾病356例(30.9％),呼吸系统疾病196例(17.0％),消化系统疾病107例(9.3％),皮肤病及性病81例(7.0％),神经系统病变74例(6.4％),泌尿系统疾病72例(6.2％),血液系统疾病70例(6.1％),内分泌与代谢性疾病47例(4.1％),自身免疫性疾病23例(2.0％),其他疾病127例(11.0％).直接影响肿瘤诊疗方案的制定为771例(66.9％);不影响方案的制定为313例(27.1％);不确定/无法判断的为69例(6.0％).结论:心血管疾病是恶性肿瘤患者合并的主要非肿瘤性疾病.非肿瘤性疾病是影响恶性肿瘤诊疗方案制定的重要因素.

Objective:To investigate the types of non-tumor diseases in patients with cancer, and to explore the effects of those dis-eases on the diagnosis and treatment of cancer patients. Methods:We collected the medical records of cancer patients from January 2013 to December 2017 in Peking University Cancer Hospital, and screened for non-tumor diseases. The clinical records of the patients in this group were analyzed retrospectively, and the effects of those diseases on the diagnosis and treatment of tumors were dis-cussed. Results:Of the 1,323 cases of inter-hospital consultation, 1,153 cases of non-tumor disease (87.2％) were selected. There were 773 men (67.0％) and 380 women (33.0％) included. The median age was 62 (14-90) years. The primary tumor types included lung can-cer, gastric cancer, lymphoma, colorectal cancer, esophageal cancer, breast cancer, malignant melanoma, liver cancer, cholangiocarci-noma/gallbladder cancer, pancreatic cancer, and other tumors. Non-neoplastic diseases included cardiovascular disease in 356 cases (30.9％), respiratory system disease (17.0％) in 196 cases, digestive system disease in 107 cases (9.3％), skin and venereal diseases in 81 cases (7.0％), nervous system lesions (6.4％) in 74 cases, urinary system disease in 72 cases (6.2％), blood disease in 70 cases (6.1％), en-docrine and metabolic diseases in 47 cases (4.1％), autoimmune disease in 23 cases (2.0％), and other diseases (11.0％) in 127 cases. Impact on tumor diagnosis and treatment was as follows:direct, 771 cases (66.9％);no influence, 313 cases (27.1％);and uncertain, 69 cases (6.0％). Conclusions:Cardiovascular disease is a major non-tumor disease associated with cancer. Non-neoplastic diseases are important factors affecting the diagnosis and treatment plans of cancer.