Cheng D-L, Hu Y-X, Hu P-Q, Wen G, Liu K
Medical Imaging Center, Nanfang Hospital, Southern Medial University, Guangzhou, People's Republic of China.
Medical Imaging Center, Nanfang Hospital, Southern Medial University, Guangzhou, People's Republic of China.
Clin Radiol. 2017 Jul;72(7):610.e1-610.e7. doi: 10.1016/j.crad.2017.02.007. Epub 2017 Mar 11.
To delineate the multisection computed tomography (MSCT) features and the clinical characteristics of primary pulmonary mucoepidermoid carcinoma (PMEC). Prognostic factors were also analysed.
A retrospective study was undertaken to investigate the medical records and MSCT performance of histopathologically confirmed PMECs from 2007 to 2015.
A total of 83.3% of patients with high-grade PMECs were aged >40 years, whereas there were 1.5-times more women than men with low-grade PMECs. Cough (n=29) and haemoptysis (n=12) were the most common symptoms. Upon MSCT, 30 cases showed a round or lobulate mass, and few demonstrated bronchial-wall thickening or cavities. Distal obstruction (n=14) and "air crescent sign" (n=5) could be detected. Tumours showed mild (n=19), moderate (n=5), and marked enhancement (n=5). Moreover, 18 cases showed foci of low density in lesions. Mean survival for patients with low-grade PMECs was 59.2 months, whereas that for high-grade PMECs was 20.4 months; 3-year survival rates were 55% and 14%, respectively. Tumour staging was a significant independent predictor of survival according to the Cox proportional hazards model.
High-grade PMECs occurred more frequently in patients aged >40 years and were more predominant in men. Young females were predisposed to having low-grade PMECs. MSCT revealed an oval or lobulate mass with mild enhancement, as manifested by calcification and visible mucus lakes, which may be suggestive of PMECs. Furthermore, a central nodule or mass may suggest low-grade PMECs; high-grade PMECs tend to be peripheral and associated with lymph-node metastasis. Pathological grade, lymph node metastasis, and TNM stage correlate with the survival of patients with PMEC.
阐述原发性肺黏液表皮样癌（PMEC）的多排螺旋CT（MSCT）特征及临床特点，并分析其预后因素。
回顾性研究2007年至2015年组织病理学确诊的PMEC患者的病历及MSCT表现。
83.3%的高级别PMEC患者年龄>40岁，而低级别PMEC患者中女性人数是男性的1.5倍。咳嗽（n=29）和咯血（n=12）是最常见的症状。MSCT检查时，30例表现为圆形或分叶状肿块，少数表现为支气管壁增厚或空洞。可检测到远端阻塞（n=14）和“空气半月征”（n=5）。肿瘤表现为轻度强化（n=19）、中度强化（n=5）和明显强化（n=5）。此外，18例病变内可见低密度灶。低级别PMEC患者的平均生存期为59.2个月，高级别PMEC患者为20.4个月；3年生存率分别为55%和14%。根据Cox比例风险模型，肿瘤分期是生存的重要独立预测因素。
高级别PMEC在年龄>40岁的患者中更常见，男性更为突出。年轻女性易患低级别PMEC。MSCT显示椭圆形或分叶状肿块，强化程度较轻，表现为钙化和可见黏液湖，这可能提示PMEC。此外，中央结节或肿块可能提示低级别PMEC；高级别PMEC往往位于周边并伴有淋巴结转移。病理分级、淋巴结转移和TNM分期与PMEC患者的生存相关。
