Carretta A, Canneto B, Calori G, Ceresoli G L, Campagnoli E, Arrigoni G, Vagani A, Zannini P
Department of Thoracic Surgery, Scientific Institute H San Raffaele, Milan, Italy.
Eur J Cardiothorac Surg. 2001 Aug;20(2):367-71. doi: 10.1016/s1010-7940(01)00733-3.
The incidence of adenocarcinoma and bronchoalveolar carcinoma has increased in recent years. The aim of this study was to retrospectively evaluate radiological and pathological factors affecting survival in patients with bronchoalveolar carcinoma (BAC) or BAC associated with adenocarcinoma who underwent surgical treatment.
From May 1988 to September 1999, 49 patients with BAC or BAC and adenocarcinoma underwent surgical treatment. Complete resection was performed in 42 patients. In these patients the impact of the following factors on survival was evaluated: stage, TNM status, radiological and pathological findings (percentage of bronchoalveolar carcinoma in the tumour, presence or absence of sclerosing and mucinous patterns, vascular invasion and lymphocytic infiltration).
Twenty-nine patients were male and 20 female. Mean age was 63 years. Five-year survival was 54%. Univariate analysis of the patients who underwent complete resection demonstrated a favourable impact on survival in stages Ia and Ib (P = 0.01) and in the absence of nodal involvement (P = 0.02) and mucinous patterns (P = 0.02). Mucinous pattern was also prognostically relevant at multivariate analysis (P = 0.02). In the 27 patients with stage Ia and Ib disease, univariate analysis demonstrated that the absence of mucinous pattern (P = 0.006) and a higher percentage of BAC (P = 0.01) favourably influenced survival. The latter data were also confirmed by multivariate analysis (P = 0.01).
Surgical treatment of early-stage BAC and combined BAC and adenocarcinoma is associated with favourable results. However, the definition of prognostic factors is of utmost importance to improve the results of the treatment. In our series tumours of the mucinous subtype and with a lower percentage of BAC had a worse prognosis.
近年来腺癌和细支气管肺泡癌的发病率有所上升。本研究的目的是回顾性评估影响接受手术治疗的细支气管肺泡癌（BAC）或与腺癌相关的BAC患者生存的放射学和病理学因素。
1988年5月至1999年9月，49例BAC或BAC合并腺癌患者接受了手术治疗。42例患者进行了完整切除。在这些患者中，评估了以下因素对生存的影响：分期、TNM状态、放射学和病理学表现（肿瘤中细支气管肺泡癌的百分比、硬化和黏液样模式的有无、血管侵犯和淋巴细胞浸润）。
男性29例，女性20例。平均年龄63岁。5年生存率为54%。对接受完整切除的患者进行单因素分析显示，Ia期和Ib期（P = 0.01）、无淋巴结受累（P = 0.02）和无黏液样模式（P = 0.02）对生存有有利影响。在多因素分析中，黏液样模式也与预后相关（P = 0.02）。在27例Ia期和Ib期疾病患者中，单因素分析显示无黏液样模式（P = 0.006）和较高的BAC百分比（P = 0.01）对生存有有利影响。多因素分析也证实了后者的数据（P = 0.01）。
早期BAC以及合并BAC和腺癌的手术治疗效果良好。然而，定义预后因素对于改善治疗结果至关重要。在我们的系列研究中，黏液样亚型且BAC百分比较低的肿瘤预后较差。
