Clinical features of pulmonary malignancies in patients younger than 30 years of age / 中国医学科学院学报

ABSTRACT

<p><b>OBJECTIVE</b>To analyse the clinical features of young patients with pulmonary malignancies.</p><p><b>METHOD</b>The clinical data of 58 young (< 30 years) patients with pulmonary malignancies who were treated in our hospital were retrospectively analyzed.</p><p><b>RESULTS</b>Out of these 58 patients, adenocarcinoma was most common (n=23, 39.66%). Accompanied tumors were seen in two patients. Occupational or environmental factors were noted in two patients. Histories of smoking were noted in 10 patients (17.24%), and all of them were patients with epithelial tumor patients. Four patients had family history of tumors. The mean time from the onset of disease to confirmed diagnosis was (5.98+/-8.95) months. The initial misdiagnosis rate was 37.9% (n=23), with pulmonary tuberculosis as the most common misdiagnosis. The proportions of advanced-stage patients (stage III B and IV) and moderate to poor-differentiated tumor accounted for 59.26% (16/27) and 77.8% (14/18), respectively in 27 patients with non-small cell lung cancer. The proportion of tumors in limited stage was 72.73% in 11 patients with small cell lung cancer, and most patients (54.55) were not sensitive to conventional chemotherapy. In 6 patients with carcinoid, 4 patients were central and the other 2 patients were peripheral, and all of them presented as Cushing syndrome; CgA, AE1/AE3, Syn, and NSE were positive in immunohistochemical staining; and surgical operation was the main treatment for them. In 6 patients with carcinomas of salivary gland type, all cases were central; no lymph nodes metastasis was found in the postoperative specimen; and surgical operation was also the main treatment for these patients. In 3 patients with primitive neuroectodermal tumors, the tumors were highly malignant and invasive, and the development of primitive neuroectodermal tumors was closely related with pleura. Immunohistochemical staining showed that the tumor cells were positive for CD99. Multiple nodules in bilateral lungs were presented in 2 patients with anaplastic large cell lymphomas, in which CD30 was positive in tumor cells; chemotherapy was the main therapy for these two patients. In one patient with synovial sarcoma, the tumor was giant and highly malignant and invasive; it was divided into many cavities filled with bloody fluid and white cheese-like substances; immunohistochemical analysis showed positive vimentin and AE1/AE3.</p><p><b>CONCLUSIONS</b>The pulmonary malignancies in young patients tend to be complicated. The treatment strategy should be based on the specific conditions of each patient.</p>