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早期结节型细支气管肺泡癌

[Nodular bronchioloalveolar carcinoma at early stage].

作者信息

Mazieres J, Daste G, Giron J, Marson V, Berjaud J, Dahan M, Bachaud J-M, Carles P, Didier A

机构信息

Service de Pneumologie, CHR Rangueil, Toulouse, France.

出版信息

Rev Mal Respir. 2003 Feb;20(1 Pt 1):61-7.

Abstract

INTRODUCTION

The aim of our study was to describe the main characteristics of bronchioloalveolar carcinoma (BAC) in the light of the latest WHO classification. The clinical, pathological and radiological features of 16 consecutive resected cases of early BAC (stage IA) were reviewed.

METHODS

Retrospective pathology of 249 adenocarcinomas over a 32 months period.

RESULTS

Computerised tomography (CT) features which supported a diagnosis of BAC included a peripheral location, irregular margins forming a star pattern, pleural tagging, ground-glass attenuation and an air bronchogram. Immunochemistry was positive in all cases for cytokeratins 7 and 19, EMA and TTF-1, but was only variably positive for ACE, P53 and MIB-1. For 14 out of 16 patients clinical outcome was favourable with no evidence to date of recurrence since surgery. Of the others, one developed extra-thoracic metastases and the other a local recurrence requiring further surgery.

CONCLUSION

Recognising these characteristics of BAC is important as early diagnosis and treatment of this condition can be associated with an excellent prognosis.

摘要

引言

我们研究的目的是根据世界卫生组织的最新分类描述细支气管肺泡癌(BAC)的主要特征。回顾了16例连续切除的早期BAC(IA期)病例的临床、病理和放射学特征。

方法

对32个月期间的249例腺癌进行回顾性病理分析。

结果

支持BAC诊断的计算机断层扫描(CT)特征包括外周位置、形成星状图案的不规则边缘、胸膜标记、磨玻璃样衰减和气支气管造影。免疫组化在所有病例中细胞角蛋白7和19、上皮膜抗原(EMA)和甲状腺转录因子-1(TTF-1)均呈阳性,但血管紧张素转换酶(ACE)、P53和MIB-1仅呈不同程度阳性。16例患者中有14例临床结局良好,自手术以来迄今无复发证据。其他患者中,1例发生胸外转移,另1例发生局部复发需要进一步手术。

结论

认识到BAC的这些特征很重要,因为这种疾病的早期诊断和治疗可能与良好的预后相关。

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