Yu Chang-Hai, Li Jie, Yu Jian-Qi, Wang Bo, Wang Tao, Wang Dian-Jun
Department of Thoracic Surgery, First Affiliated Hospital, General Hospital of People's Liberation Army, Beijing, China.
Zhonghua Yi Xue Za Zhi. 2007 Jan 2;87(1):41-3.
To investigate the clinicopathological features and prognosis of bronchial mucoepidermoid carcinoma.
Twenty-one with mucoepidermoid carcinoma, 16 males and 5 females, aged 40.8 (15 ~ 72) underwent surgical treatment, 13 cases undergoing lobectomy, 3 sleeve lobectomy, 4 pneumonectomy, and 1 case thoracic exploration, from February 1988 to June 2005. Bronchoscopy was done in all patients before operation. Follow-up was made for 68.3 months on average.
Most patients presented the respiratory symptoms such as cough, dyspnea, hemoptysis, and obstructive pneumonia. Biopsy examination through bronchoscopy confirmed the diagnosis of bronchial mucoepidermoid carcinoma in 16 cases. Pathology showed 17 cases of low grade tumor and 4 cases of high grade tumor. Follow-up showed that 17 cases of low-grade group (stage T(1 - 3)N(0 - 1)M(0)) all survived, 8 of which had survived for more than 5 years, including one patient with hilar lymph node metastasis. However, none of the 4 cases with high-grade tumor survived for more than 1 year except one that survived for 13 months.
Patients with low-grade mucoepidermoid carcinoma can be expected to be cured through curative resection, however, patients in high-grade group have poor prognosis because of metastasis. TNM staging, malignancy grade, and local lymph node metastasis play the key roles in prediction of prognosis.
探讨支气管黏液表皮样癌的临床病理特征及预后。
1988年2月至2005年6月,21例黏液表皮样癌患者接受了手术治疗,其中男性16例,女性5例,年龄40.8岁(15~72岁)。13例行肺叶切除术,3例行袖式肺叶切除术,4例行全肺切除术,1例行开胸探查术。所有患者术前均行支气管镜检查。平均随访68.3个月。
多数患者表现为咳嗽、呼吸困难、咯血及阻塞性肺炎等呼吸道症状。经支气管镜活检确诊支气管黏液表皮样癌16例。病理显示低级别肿瘤17例,高级别肿瘤4例。随访显示,17例低级别组(T(1 - 3)N(0 - 1)M(0)期)患者均存活,其中8例存活超过5年,包括1例有肺门淋巴结转移的患者。然而,4例高级别肿瘤患者除1例存活13个月外,均未存活超过1年。
低级别黏液表皮样癌患者有望通过根治性切除治愈,而高级别组患者因转移预后较差。TNM分期、恶性程度及局部淋巴结转移在预后预测中起关键作用。