Dumont P, Gasser B, Roeslin N, Wihlm J M, Morand G, Witz J P
Service de Chirurgie Thoracique, CHU de Strasbourg.
Rev Mal Respir. 1989;6(4):329-34.
The postoperative outcome of bronchiolo-alveolar epithelioma (EBA) is unpredictable. We question whether a study of the anatomo-pathological structures would enable us to detect prognostic indicators. The clinical characteristics, histopathology and outcome of 52 cases of EBA were studied. 31 tumours were detected in a systematic fashion; 50 patients had excision of the tumour and in 39 cases there was no invasion of the lymphatics. 10 were of the multicentric variety and 42 were of the nodular variety and 9 of these were the centre of an inflammatory lympho-plasmocytic reaction. 20 cases revealed mucinous differentiation and 32 were non-mucinous. In the latter cases nucleo-cytoplasmic anomalies were only slightly increased or even absent. Blood vessel invasion was present in 12 cases and metastases to the air spaces in 20. The overall survival was 83% in the first year, 65% in the second year, 42% at five years and 26.5% at 10 years. The nodular lesions were compatible with a significantly better survival than the diffuse forms. Other characteristics such as whether the tumour was mucinous or not, inflammatory, showed nuclear anomalies, blood vessel invasion and airborne metastases did not seem to affect survival.
细支气管肺泡上皮瘤（EBA）的术后预后难以预测。我们质疑对解剖病理结构的研究是否能使我们检测出预后指标。对52例EBA的临床特征、组织病理学和预后进行了研究。31例肿瘤通过系统方式检测到；50例患者进行了肿瘤切除，39例未见淋巴管侵犯。10例为多中心型，42例为结节型，其中9例为炎症性淋巴细胞 - 浆细胞反应中心。20例显示黏液样分化，32例为非黏液样。在后一种情况下，核质异常仅略有增加甚至不存在。12例存在血管侵犯，20例有气腔转移。第一年总生存率为83%，第二年为65%，五年时为42%，十年时为26.5%。结节性病变的生存率明显优于弥漫性病变。其他特征，如肿瘤是否为黏液样、是否有炎症、是否显示核异常、血管侵犯和气腔转移似乎并不影响生存率。
