摘要
目的:回顾分析细支气管肺泡癌(bronchioloalveolar carcinoma,BAC)的临床表现、影像学特点及其病理基础,采用Cox回归模型探讨影响BAC疗效与预后的临床因素。方法:按照2009年国际肺癌研究协会(IASLC)公布的新修订的肺癌分期系统进行TNM分期,通过统计学方法总结上海交通大学附属瑞金医院2000年1月至2010年6月期间收治的经病理证实的170例BAC患者的临床资料。结果:本组病例男女之比为1:1.4,吸烟与无吸烟之比为1:2.9,中位生存期为6.48年。单纯BAC和伴有BAC成分的腺癌可能与吸烟关系不大。病理类型、影像学类型和治疗方案的组间生存曲线差异有统计学意义(P<0.05)。Cox多因素分析显示病理类型、影像学表现、TNM分期以及是否放化疗与BAC患者预后有关;而性别、年龄、吸烟以及靶向治疗与BAC患者的生存时间无关。结论:BAC发病在非吸烟者中多见,单纯性BAC较其他病理类型有较长的生存期;BAC患者中咳大量泡沫样痰的症状并不多见,治疗上以尽可能手术为主,以结合化疗、放疗、分子靶向治疗的综合治疗为原则;EGFR-TK1的一线治疗可用于晚期BAC。
Objective： To investigate clinical symptoms, radiological and pathological characteristics, and prognostic factors of bronchioloalveolar cell carcinoma （BAC）. Methods： Clinical data of 170 BAC patients admitted to our hospital between January 2000 and June 2010 were retrospectively analyzed based on 2009 IASLC TNM Classification. The mono-factorial survival curve was plotted with the Kaplan-Meier method. The variance associated with prognosis was evaluated by Log-rank test. A multivariate analysis of prog- nostic factors was performed with Cox proportional hazard regression model. Results： The male-to-female ratio was 1 ： 1.4, and the ratio of smokers to non-smokers was 1：2.9. The median survival time was 6.48 years. Simple BAC and adenoma with BAC had little correla- tion with smoking. There was statistical significance in the intergroup survival curves among the pathological type, radiological type and therapeutic regimen （ P〈 0.05 ）. Multivariate analysis indicated that pathological type, radiological type, TNM staging and mode of treatment may correlate to the prognosis of BAC patients. However, sex, age and targeted therapy were not related to the survival of these patients. Conclusion： The incidence of BAC is common in non-smokers. Patients with simple BAC has a longer survival compared with those with BAC of other pathological types. Large amount of foamy sputum is not commonly seen in BAC patients. The treatment of choice for this disease is surgery with adjuvant therapy such as chemotherapy, radiotherapy, and molecular targeted therapy. EGFR--TK1 is recommended as the first-line treatment for advanced BAC patients.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2011年第3期170-174,共5页
Chinese Journal of Clinical Oncology
关键词
肺癌
细支气管肺泡癌
预后
生存期
Lung cancer
Bronchioalveolar carcinoma
Prognosis
Survival
