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手术切除治疗黏液型细支气管肺泡癌患者。

Surgical resection for patients with mucinous bronchioloalveolar carcinoma.

机构信息

Second Department of Surgery, University of Occupational and Environmental Health, Kitakyushu, Japan.

出版信息

Asian J Surg. 2010 Apr;33(2):89-93. doi: 10.1016/S1015-9584(10)60015-2.

Abstract

BACKGROUND

The clinical features of mucinous bronchioloalveolar carcinoma (BAC) have remained unclear due to the low incidence of this disease. This study investigated the clinicopathological features and the surgical outcome in patients with mucinous BAC.

METHODS

We clinicopathologically evaluated 782 patients who underwent resection for nonsmall cell carcinoma between 1999 and 2008, of whom, 13 (1.6%) demonstrated to have mucinous BAC.

RESULTS

The patients with mucinous BAC included six men and seven women. The mean age was 69.1 years (range: 55-78 years). Eight patients (61.5%) had a smoking habit. No patients had any subjective symptoms. The tumour diameter ranged from 1.2 cm to 10 cm. The surgical procedures included 11 lobectomies, and two partial resections of affected lobes. The pathological stage was IA in eight patients, IB in two, IIA in two, and IIIA in one. None of the patients had lymph node metastases or lymphovascular invasion. The overall postoperative 5-year survival rate was 52.5%. The 5-year survival rate according to tumour diameter was 100% in patients with tumours ≤ 3 cm, and 25.1% in patients with tumours > 3 cm. Two patients died due to pulmonary metastases, and one died from carcinomatous pleuritis and pulmonary metastases.

CONCLUSION

Patients with small mucinous BAC (≤ 3 cm) in diameter showed excellent prognosis after surgical resection. However, mucinous BAC > 3 cm in diameter tended to recur with pulmonary metastasis.

摘要

背景

由于该病发病率低,黏液性细支气管肺泡癌(BAC)的临床特征仍不清楚。本研究调查了黏液性 BAC 患者的临床病理特征和手术结果。

方法

我们对 1999 年至 2008 年间因非小细胞癌行切除术的 782 例患者进行了临床病理评估,其中 13 例(1.6%)为黏液性 BAC。

结果

黏液性 BAC 患者包括 6 例男性和 7 例女性。平均年龄为 69.1 岁(范围:55-78 岁)。8 例(61.5%)有吸烟史。无患者有任何主观症状。肿瘤直径为 1.2-10cm。手术方式包括 11 例肺叶切除术和 2 例受累肺叶部分切除术。病理分期为 IA 期 8 例,IB 期 2 例,IIA 期 2 例,IIIA 期 1 例。无患者有淋巴结转移或脉管侵犯。所有患者的总体术后 5 年生存率为 52.5%。肿瘤直径≤3cm 的患者 5 年生存率为 100%,肿瘤直径>3cm 的患者 5 年生存率为 25.1%。2 例患者死于肺转移,1 例死于癌性胸膜炎和肺转移。

结论

直径≤3cm 的小黏液性 BAC 患者手术后预后良好。然而,直径>3cm 的黏液性 BAC 倾向于复发并发生肺转移。

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