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纤毛黏液结节状乳头状肿瘤的临床病理特征及预后

Clinicopathological features and prognosis of ciliated muconodular papillary tumor.

作者信息

Shao Kang, Wang Yalong, Xue Qi, Mu Juwei, Gao Yushun, Wang Yonggang, Wang Bingzhi, Zhou Lina, Gao Shugeng

机构信息

Department of Thoracic Surgery, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People's Republic of China.

Department of Pathology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People's Republic of China.

出版信息

J Cardiothorac Surg. 2019 Jul 24;14(1):143. doi: 10.1186/s13019-019-0962-3.

Abstract

BACKGROUNDS

The pulmonary ciliated muconodular papillary tumor (CMPT) is a very rare tumor with only several case reports in published literatures, and its clinicopathological features, standard treatment methods and prognosis has not been well defined.

METHODS

Two cases of CMPT diagnosed and treated in our hospital and 39 cases reported in the published literature were analyzed retrospectively.

RESULTS

The cohort of 41 CMPT patients comprised of 20 males and 21 females, aged 9-84 years. The diameter of the primary tumor was 0.3-4.5 cm. Most of these lesions were subsolid nodules, as observed on computed tomography and easily misdiagnosed as early lung adenocarcinoma. Tumors of 26 patients were stained by immunohistochemistry method, which revealed that CK7, CEA, and TTF-1 were positive and CK20 was negative in most patients. The results of gene alternation demonstrated mutations in EGFR, KRAS, and BRAF and ALK rearrangements in CMPT. All the patients underwent surgical treatment and did not receive postoperative adjuvant therapy. The follow-up duration was 0-120 months, and no case of tumor recurrence was found until the final follow-up.

CONCLUSIONS

The incidence of CMPT was low and rate of image misdiagnosis high. Immunohistochemistry is helpful for accurate diagnosis of CMPT. Sub-lobectomy may be proper and adjuvant treatment should be avoided since the disease is now prone to benign lesions. Furthermore, since the biological behavior of this tumor is not yet fully elucidated, additional case data are essential for accurate conclusions.

摘要

背景

肺纤毛黏液结节状乳头状肿瘤(CMPT)是一种非常罕见的肿瘤,已发表的文献中仅有几例病例报告,其临床病理特征、标准治疗方法及预后尚未明确。

方法

回顾性分析我院诊治的2例CMPT患者及已发表文献报道的39例病例。

结果

41例CMPT患者中,男性20例,女性21例,年龄9 - 84岁。原发肿瘤直径0.3 - 4.5厘米。这些病变大多为亚实性结节,在计算机断层扫描上可见,易误诊为早期肺腺癌。26例患者的肿瘤进行了免疫组化染色,结果显示大多数患者CK7、CEA和TTF - 1呈阳性,CK20呈阴性。基因改变结果显示CMPT中存在EGFR、KRAS和BRAF突变以及ALK重排。所有患者均接受了手术治疗,未接受术后辅助治疗。随访时间为0 - 120个月,直至最后一次随访未发现肿瘤复发病例。

结论

CMPT发病率低,影像误诊率高。免疫组化有助于CMPT的准确诊断。由于该疾病目前倾向于良性病变,肺叶下切除可能合适,应避免辅助治疗。此外,由于该肿瘤的生物学行为尚未完全阐明,需要更多病例数据才能得出准确结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1ff/6651997/b6b527e9d373/13019_2019_962_Fig1_HTML.jpg

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