Takao M, Watanabe F, Shimamoto A, Sai M, Riku G, Onoda K, Shimono T, Shimpo H, Yada I, Namikawa S
Department of Thoracic Surgery, Mie University School of Medicine, Tsu, Japan.
Kyobu Geka. 2002 Jan;55(1):15-9.
We studied multiple primary lung cancers (MPLCs) in 921 patients who had undergone operation for primary lung cancer since March 1979 in Mie University Hospital. There were 14 synchronous and 5 metachronous MPLCs. Combination of synchronous MPLCs were adenocarcinoma (ADC)/ADC in 7, squamous cell carcinoma (SCC)/SCC in 3, and ADC/adenosquamous cell carcinoma, ADC/small cell carcinoma, ADC/large cell carcinoma and multiple AAH in one. The incidence of synchronous MPLCs was 0.7% (6/815 pts) before May 1999 and 7.5% (8/106 pts) after June 1999 when HRCT was introduced for preoperative evaluation and postoperative follow-up. Six cases with multiple bronchioloalveolar carcinomas (BACs) have undergone operation for last 5 years. Most of them were roentgenographically occult and the operative outcome was good in spite of limited resection. In summary, we need new strategy of diagnosis and operative procedure for peripheral small adenocarcinoma, because multiple MPLCs of BAC are not rare.
我们对1979年3月以来在三重大学医院接受原发性肺癌手术的921例患者中的多原发性肺癌(MPLC)进行了研究。有14例同时性和5例异时性MPLC。同时性MPLC的组合为腺癌(ADC)/ADC 7例,鳞状细胞癌(SCC)/SCC 3例,以及ADC/腺鳞癌、ADC/小细胞癌、ADC/大细胞癌和1例多发不典型腺瘤样增生。1999年5月前同时性MPLC的发生率为0.7%(6/815例患者),1999年6月引入HRCT进行术前评估和术后随访后为7.5%(8/106例患者)。在过去5年中,有6例多细支气管肺泡癌(BAC)患者接受了手术。其中大多数在影像学上隐匿,尽管切除范围有限,但手术效果良好。总之,由于多发BAC的MPLC并不罕见,我们需要针对周围型小腺癌的新诊断和手术策略。