Raz Dan J, Kim Jae Y, Jablons David M
University of California, San Francisco, Department of Surgery, San Francisco, California 94143-0470, USA.
Curr Opin Pulm Med. 2007 Jul;13(4):290-6. doi: 10.1097/MCP.0b013e32816ebc62.
Bronchioloalveolar carcinoma accounts for 5% of lung cancers, although histologically mixed bronchioloalveolar carcinoma and adenocarcinoma account for up to 20%. Bronchioloalveolar carcinoma histology is present in a majority of tumors found on lung-cancer screening by computed tomography. We review issues surrounding the diagnosis and treatment of bronchioloalveolar carcinoma, which often differs from other types of lung cancer.
A spectrum of disease from histologically pure bronchioloalveolar carcinoma to adenocarcinoma exists. The approach to treatment of diseases within this spectrum is still evolving. Evidence on the role of sub-lobar resection, resection of multifocal disease, and pulmonary transplantation is reviewed. We also discuss epidermal growth factor receptor tyrosine kinase inhibitors, and their role in patients with bronchioloalveolar carcinoma.
An understanding of recent developments in the diagnosis and treatment of patients with bronchioloalveolar carcinoma histology is important as early detection of lung cancer becomes more common. Ongoing clinical trials will provide important information on the role of limited resection. The use of epidermal growth factor receptor tyrosine kinase inhibitors should currently be limited to patients with advanced or recurrent disease who have failed cytotoxic chemotherapy. New targeted therapies are emerging for patients with bronchioloalveolar carcinoma histology.
细支气管肺泡癌占肺癌的5%，不过组织学上混合型细支气管肺泡癌和腺癌占比可达20%。在通过计算机断层扫描进行肺癌筛查时发现的大多数肿瘤中都存在细支气管肺泡癌组织学特征。我们综述了围绕细支气管肺泡癌诊断和治疗的问题，其通常与其他类型的肺癌不同。
存在从组织学上纯粹的细支气管肺泡癌到腺癌的一系列疾病。针对这一范围内疾病的治疗方法仍在不断发展。本文综述了肺叶下切除、多灶性疾病切除及肺移植作用的相关证据。我们还讨论了表皮生长因子受体酪氨酸激酶抑制剂及其在细支气管肺泡癌患者中的作用。
随着肺癌早期检测越来越普遍，了解细支气管肺泡癌组织学患者诊断和治疗的最新进展很重要。正在进行的临床试验将提供有关有限切除作用的重要信息。目前，表皮生长因子受体酪氨酸激酶抑制剂的使用应限于细胞毒性化疗失败的晚期或复发性疾病患者。针对细支气管肺泡癌组织学患者的新靶向治疗方法正在涌现。
