Hiyoshi H, Narita K, Tachibana M, Iwanami H, Sakonji M, Tsuboi E, Kato H
Department of Surgery, Tuboi Hospital, Jisankai Medical Institute, Kohriyama, Japan.
Kyobu Geka. 1996 Sep;49(10):873-5.
This patient, a 53-year-old male, has had back pain and an abnormal shadow was detected in the right lung field on December 1989. He was admitted to the hospital for the further examination. On the diagnosis of lung cancer with high serum CEA level operation was performed on February 1990. As a results of pathological examination, histological type was adenocarcinoma and pathological stage was pT3N0M0 stage IIIA. After operation the serum CEA level was decreased immediately but it was gradually increased once again. And then 14 months later right adrenal metastasis was detected by abdominal CT with high serum CEA level and resection was performed. Similarly a solitary lymph node metastasis located in abdomen was detected and resected with high serum CEA level 28 months after second operation. In this case detection and resection of the metastatic lesion was managed effectively by serum CEA level. The patient had a good operative course and is alive 76 months after first operation without any evidence or recurrence.
该患者为53岁男性，1989年12月出现背痛，右肺野发现异常阴影。他因进一步检查入院。1990年2月，在诊断为肺癌且血清癌胚抗原（CEA）水平升高的情况下进行了手术。病理检查结果显示，组织学类型为腺癌，病理分期为pT3N0M0 IIIA期。术后血清CEA水平立即下降，但随后又逐渐再次升高。14个月后，腹部CT检查发现右肾上腺转移，血清CEA水平升高，遂进行了切除。同样，在第二次手术后28个月，发现并切除了位于腹部的一个孤立性淋巴结转移灶，血清CEA水平升高。在该病例中，通过血清CEA水平有效地管理了转移病灶的检测和切除。患者手术过程顺利，首次手术后存活76个月，无任何复发迹象。
