摘要
目的探讨细支气管肺泡癌(BAC)的临床特点及治疗效果,提高细支气管肺泡癌早期诊断水平,达到及时治疗的目的。方法对蚌医二附院2005～2010年收治的21例BAC患者的临床病理资料进行回顾性分析。结果临床以咳嗽、咳血或痰中带血为最多,其次为胸痛、呼吸困难,而影像学检查主要表现为单发结节型、多发结节型及肺炎浸润型,其中单发型结节最多,有11例,占总数的52.4%。首次就诊仅7例确诊,误诊率达66.7%(14/21),行痰培养检查及纤维支气管镜检查均未找到肿瘤细胞,在外院误诊时间为1～18个月。其中有15例通过手术行相应肺叶切除及淋巴清扫术,10例接受化疗,4例未接受任何治疗,21例均经病理组织学检查证实为细支气管肺泡癌,并且无法确认吸烟与细支气管肺泡癌的发生有无明确的相关性。结论细支气管肺泡癌易误诊,影像学检查表现具有特殊性,单发结节型的外科治疗效果好,对不能及时确诊的病例应及时做进一步相关检查以减少误诊,到达肺癌晚期的病人及不能耐受手术的患者可行化疗处理。
Objective To study the clinical characteristic and therapeutic results of bronchioloalveolar carcinoma（BAC）,and to improve the early diagnosis and treatment.Methods A retrospective clinicopathologic analysis was conducted on 21 patients with bronchioloalveolar carcinoma treated in our hospital from 2005 to 2010.Results The cough,hemoptysis and bloody sputum were the most symptoms,followed by chest pain and dyspnea.The imaging examination manifested as solitary nodule,multiple nodular and infiltrating pneumonia,in which the solitary nodule was mainly found（11 cases,accounting for 52.4%）.The rate of confirmed diagnosis during the first diagnosis was only 7 cases;the rate of misdiagnosis was 66.7%（14/21）.The sputum culture examination and fiberoptic bronchoscopy did not found tumor cells,and the misdiagnosis time was 1-18 months before the patients come to our hospital.15 cases underwent the lobectomy and lymph node dissection;10 cases received chemotherapy,4 cases gave up treatment.All 21 cases were confirmed by histopathologic examination to be the bronchioloalveolar carcinoma.The correlation between the smoking and incidence rate cannot be confirmed.Conclusion Bronchioloalveolar carcinoma was easy to be misdiagnosed in clinic.The imaging manifestations have its special characters.The patients with solitary nodule type bronchioloalveolar carcinoma have a better prognosis after surgical treatment.For the cases cannot be confirmed with confidence,further relative examinations should be performed so as to reduce the available misdiagnosis.The chemotherapy treatment is the best choose for the patients with advanced lung cancer and lower tolerance for operation.
出处
《中华全科医学》
2011年第10期1531-1531,1593,共2页
Chinese Journal of General Practice
关键词
肺肿瘤
细支气管肺泡癌
诊断
治疗
Lung neoplasms
Bronchioloalveolar carcinoma
Diagnosis
Therapy
