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肺癌转移灶的分布模式与原发肿瘤组织学类型的关系:一项尸检研究。

Distribution patterns of the metastases of the lung carcinoma in relation to histological type of the primary tumor: An autopsy study.

作者信息

Milovanovic Ivana Savic, Stjepanovic Mihailo, Mitrovic Dragan

机构信息

Institute of Pathology, School of Medicine, University of Belgrade, 11000 Belgrade, Serbia.

Clinic of Pulmonology, Clinical Center of Serbia, 11000 Belgrade, Serbia.

出版信息

Ann Thorac Med. 2017 Jul-Sep;12(3):191-198. doi: 10.4103/atm.ATM_276_16.

Abstract

INTRODUCTION

Lung cancer is among leading causes of death worldwide. Different histological types of the lung carcinoma show significant differences in behavior.

OBJECTIVES

The aim of this study is to determine the distribution patterns of metastases of different lung cancer histological types in autopsied individuals.

METHODS

Protocols from all autopsies performed at the Institute of Pathology from 2008 till 2014 were reviewed retrospectively, and information on individuals' age, sex, histological type of primary lung cancer, presence and location of metastases, and causes of death were recorded.

RESULTS

More than 90% of the individuals with lung cancer metastases were older than 50 years (mean age: 64.5 ± 10.3), with two-fold male predominance. The most frequent histological type in both sexes was adenocarcinoma (48%). Although, in general, hematogenous metastases were mostly found in the liver and adrenal glands, various histological types of lung cancer show specific dissemination patterns. Metastases in adrenal glands derived mostly from adenocarcinoma and large-cell carcinoma. Metastases in the intestines most frequently originated from large-cell carcinoma ( = 0.01). Metastatic complications and bronchopneumonia were the most frequent causes of death.

CONCLUSIONS

While, overall, the most frequent hematogenous metastases occur in the liver and adrenal glands, various histological types of lung cancer show specific dissemination patterns. Knowing distribution of metastases is essential for making algorithms of treatment, as well as for improving clinical assessment of the patients with unclear clinical findings and suspicion on occult primary lung cancer.

摘要

引言

肺癌是全球主要死因之一。不同组织学类型的肺癌在行为表现上存在显著差异。

目的

本研究旨在确定不同组织学类型肺癌在尸检个体中的转移分布模式。

方法

回顾性分析了2008年至2014年在病理研究所进行的所有尸检记录,记录了个体的年龄、性别、原发性肺癌的组织学类型、转移的存在及位置以及死因。

结果

超过90%发生肺癌转移的个体年龄超过50岁(平均年龄:64.5±10.3),男性占比是女性的两倍。两性中最常见的组织学类型是腺癌(48%)。虽然一般来说,血行转移大多见于肝脏和肾上腺,但不同组织学类型的肺癌显示出特定的播散模式。肾上腺转移大多源自腺癌和大细胞癌。肠道转移最常源自大细胞癌(P = 0.01)。转移并发症和支气管肺炎是最常见的死因。

结论

总体而言,血行转移最常发生于肝脏和肾上腺,但不同组织学类型的肺癌显示出特定的播散模式。了解转移分布对于制定治疗方案以及改善对临床发现不明确且怀疑隐匿性原发性肺癌患者的临床评估至关重要。

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