Zhang X P, Hu P Z, Shen S S, Li X Y
Department of Radiation Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China.
Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, China.
Zhonghua Zhong Liu Za Zhi. 2018 Jun 23;40(6):452-455. doi: 10.3760/cma.j.issn.0253-3766.2018.06.010.
To investigate the clinicopathological characteristics, therapy and prognosis of patients with pulmonary mucoepidermoid carcinoma. The clinical data of 87 patients diagnosed as pulmonary mucoepidermoid carcinoma at The First Affiliated Hospital of Zhengzhou University from April 2011 to May 2016 were retrospectively analyzed. The clinicopathological features were summarized and the prognoses were analyzed. Among the 87 patients with lung mucoepidermoid carcinoma, 53 were male and 34 were female, the gender ratio between men and women was 1.56∶1.The ages of patients were from 16 to 79 years and the median age was 52.5 years. Seventeen cases were diagnosed as stage Ⅰ, 28 cases were stage Ⅱ, 26 cases were stage Ⅲ, 16 cases were stage Ⅳ.Thirty-six patients were examined by immunohistochemistry, of which 29 cases were cytokeratin (CK) 5/6 positive, 29 cases were CK7 positive, 10 cases were CK positive, 28 cases were p63 positive, 14 cases were p40 positive, 17 cases were thyroid transcription factor-1 (TTF-1) positive, 11 cases were NapsinA positive, 2 cases were epithelial membrane antigen (EMA) positive, 4 cases were CK8/18 positive, 3 cases were surfactant proteins A (SPA) positive, 1 case was CAM5.2 positive and 1 case was CK14 positive. Among the 87 patients, 34 cases were treated by operation alone, 23 cases were treated by operation combined with chemotherapy, 5 cases were treated by radiotherapy combined with chemotherapy, 14 cases were treated by chemotherapy alone, 2 cases were treated by particle implantation combined with chemotherapy, 2 cases were treated by local radiofrequency hyperthermia combined with chemotherapy, and 7 cases without special treatment.Five patients with brain metastasis were treated with cerebral radiotherapy combined with sequential chemotherapy. The 1-year, 2-year and 5-year survival rates of 87 patients were 90.7%, 81.6% and 46.3%, respectively. The median survival time was 60 months. The prognoses of patients with lung mucoepidermoid carcinoma were related with the clinical stage, smoking and operative therapy (all <0.05). The age distribution of patients with pulmonary mucoepidermoid is a wide range, the incidence of male is higher than that of female. The diagnosis of pulmonary mucoepidermoid carcinoma mainly relies on the morphological diagnosis and the immunohistochemical detection is non-specific. The prognoses of patients with lung mucoepidermoid carcinoma are related with clinical stage, smoking and operative therapy. For patients who are inoperable and with single distant metastasis, local radiotherapy, other local treatment and chemotherapy can significantly improve their prognoses.
探讨肺黏液表皮样癌患者的临床病理特征、治疗方法及预后情况。回顾性分析2011年4月至2016年5月在郑州大学第一附属医院确诊为肺黏液表皮样癌的87例患者的临床资料。总结临床病理特征并分析预后情况。87例肺黏液表皮样癌患者中，男性53例，女性34例，男女比例为1.56∶1。患者年龄为16～79岁，中位年龄为52.5岁。17例诊断为Ⅰ期，28例为Ⅱ期，26例为Ⅲ期，16例为Ⅳ期。36例患者进行了免疫组化检查，其中29例细胞角蛋白（CK）5/6阳性，29例CK7阳性，10例CK阳性，28例p63阳性，14例p40阳性，17例甲状腺转录因子-1（TTF-1）阳性，11例NapsinA阳性，2例上皮膜抗原（EMA）阳性，4例CK8/18阳性，3例表面活性蛋白A（SPA）阳性，1例CAM5.2阳性，1例CK14阳性。87例患者中，单纯手术治疗34例，手术联合化疗23例，放疗联合化疗5例，单纯化疗14例，粒子植入联合化疗2例，局部射频热疗联合化疗2例，未行特殊治疗7例。5例脑转移患者接受了脑放疗联合序贯化疗。87例患者的1年、2年和5年生存率分别为90.7%、81.6%和46.3%。中位生存时间为60个月。肺黏液表皮样癌患者的预后与临床分期、吸烟及手术治疗有关（均P<0.05）。肺黏液表皮样癌患者年龄分布范围广，男性发病率高于女性。肺黏液表皮样癌的诊断主要依靠形态学诊断，免疫组化检测不具有特异性。肺黏液表皮样癌患者的预后与临床分期、吸烟及手术治疗有关。对于无法手术且有单个远处转移的患者，局部放疗、其他局部治疗及化疗可显著改善其预后。
