Hiratsuka T, Mukae H, Ihiboshi H, Ashitani J, Katoh S, Mashimoto H, Hirosako S, Mizobe T, Matsumoto M, Matsukura S
Third Department of Internal Medicine, Miyazaki Medical College, Japan.
Nihon Kokyuki Gakkai Zasshi. 1998 May;36(5):482-7.
We report the efficacy of oral clarithromycin and inhaled beclomethasone against severe bronchorrhea in a patient with alveolar cell carcinoma. A 54-year-old man produced about 500 to 900 ml of clear and egg-white-like sputum each day. Anti-cancer chemotherapy and erythromycin therapy did not reduce the volume of sputum. After administration of clarithromycin and inhaled beclomethasone, sputum volume decreased to about 300 nl each day and the patient's ability to perform daily activities improved. Two months later, clarithromycin was stopped and the patient was treated with inhaled beclomethasone alone. Sputum volume did not increase for 6 months, although the chestroentgenographic findings gradually worsened. Then the sputum volume gradually increased. Five months after the sputum volume began to increase, he was producing about 2 liters of sputum each day and died of respiratory failure. Although the levels of CA 19-9, SLX, and CEA in serum were all within the normal range, the sputum contained high levels of CA 19-9 (1,133,620 U/ml), SLX (3,000 U/ml), and CEA (283 ng/ml). In patients with bronchorrhea, measurement of tumor markers in sputum may be useful for the diagnosis of alveolar cell carcinoma.
我们报告了口服克拉霉素和吸入倍氯米松对肺泡细胞癌患者严重支气管黏液溢的疗效。一名54岁男性每天咳出约500至900毫升清亮的蛋清样痰液。抗癌化疗和红霉素治疗均未减少痰液量。给予克拉霉素和吸入倍氯米松后，痰液量减少至每天约300毫升，患者的日常活动能力得到改善。两个月后，停用克拉霉素，仅用吸入倍氯米松治疗患者。尽管胸部X线检查结果逐渐恶化，但痰液量6个月未增加。随后痰液量逐渐增加。痰液量开始增加5个月后，他每天咳出约2升痰液，最终死于呼吸衰竭。尽管血清中CA 19-9、SLX和CEA水平均在正常范围内，但痰液中CA 19-9（1,133,620 U/ml）、SLX（3,000 U/ml）和CEA（283 ng/ml）水平很高。对于支气管黏液溢患者，检测痰液中的肿瘤标志物可能有助于肺泡细胞癌的诊断。
