Analysis of symptoms and case history data in the set of 353 patients with lung cancer in 1st Pulmonary department of Charles University, Prague


Authors: M. Marel 1;  F. Krejbich 1;  P. Stránská 1;  O. Měřička 1;  J. Homolka 1;  Z. Skácel 1;  M. Zemanová 2
Authors‘ workplace: Univerzita Karlova v Praze, 1. lékařská fakulta, I. klinika TRN VFN 1;  Univerzita Karlova v Praze, 1. lékařská fakulta, Onkologická klinika VFN 2
Published in: Čas. Lék. čes. 2009; 148: 416-423
Category: Original Article

Overview

Background.
Lung cancer (LC) incidence in men in the Czech Republic has been declining since 1995, in women it grows up continually. To analyse the characteristics of recent set of patients (pts) and contribution of their symptoms for diagnostic, treatment and prognosis we carried on the retrospective study on patients from 1st Pulmonary department from 2004-2007.

Methods and results. Men :
women ratio in the set of 353 pts was 2 : 1. The frequency of symptoms at the time of diagnosis were: cough 69%, dyspnoe 54%, loss of weight 49%, expectoration 39%, pain on the chest 37%, haemoptysis 17.7%, fever 16%, vena cava superior syndrome 3,7%. Smokers fell in to the disease in significantly younger age than nonsmokers, 63 vs. 73 years. 40% of pts with LC suffer from COPD, more frequently have had squamous type of cancer. 78% of the set was morphologically verified, most frequent types of cancer were squamous type (22.1%) followed by adenocarcinoma, 21.2%. Surgical therapy underwent 18.1% of the whole set.

We look consequently for correlation between symptoms and other data of the pts. The pts with abuse of alcohol beverage fell in to the disease in a younger age. The pts with central tumor suffer from stronger cough more frequently, at bronchoscopy had more often direct tumor changes. The pts with IV. TNM stage of LC more frequently suffer from fever and pain. Significantly fewer pts with dyspnoe, loss of weight and lower FEV1 underwent surgical resection. FEV1 was lower in pts with central than with peripheral type of tumor. In pts with direct bronchoscopical tumor changes were found more frequently haemoptysis, broader spectrum of symptoms, lower FVC and FEV1. Dyspnoe correlated with PaO2 but not with PaCO2. CRP was lower in pts with peripheral type of LC, higher in pts with small cell LC (SCLC). Occurrence of haemoptysis did not correlate with number of smoked cigarettes.

Conclusions.
In conclusion we proofed that proper taking of history case may accelerate and improve the diagnostic process.

Key words:
lung cancer, symptoms, diagnostic.


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