摘要
目的:分析原发性肺黏液表皮样癌(pulmonary mucoepidermoid carcinoma,PMEC)的临床特征,以提高对本病的认识。方法:回顾性分析2010年01月至2020年12月我院39例原发性PMEC患者的症状、肺部基础疾病、胸部CT表现、确诊方法、病理特点、治疗方法、预后等。结果:男25例,女14例,男女比例1.79∶1,发病年龄42~70岁,平均(56.13±7.94)岁,吸烟者21例(53.8%)。首发临床症状为咳嗽、咳痰21例(53.8%)、咯血5例(12.8%)、胸闷5例(12.8%)、发热3例(7.7%),5例(12.8%)体检发现,无症状。肺部基础疾病有慢性阻塞性肺疾病12例(30.8%),支气管哮喘4例(10.3%),支气管扩张症4例(10.3%),间质性肺疾病1例(2.6%),肺结核1例(2.6%),无肺部基础疾病17例(43.6%);胸部CT可见支气管内边缘光滑、边界清楚的肿块(类圆形肿块、分叶状肿块多见)、肺不张、阻塞性肺炎、胸腔积液等表现;最终患者均通过病理确诊为PMEC且排除涎腺转移可能,病理表现为低级别者28例、高级别者11例。低级别患者与高级别患者相比,OS明显优于高级别患者(P=0.000);以手术为主综合治疗组与非手术治疗组患者相比,OS明显优于非手术治疗组患者(P=0.001)。结论:原发性PMEC的临床症状及胸部CT表现多样且缺乏特异性,确诊均需组织病理学;手术是首选治疗方法;多因素分析结果显示,组织学分级是最重要和可靠的预后指标。
Objective:To analyse the clinical characteristics of primary pulmonary mucoepidermoid carcinoma(PMEC)in order to improve the understanding of this disease.Methods:A retrospective analysis of 39 patients with primary PMEC at our hospital from January 2010 to December 2020 was conducted on the symptoms,underlying lung diseases,chest CT findings,diagnostic methods,pathological characteristics,treatment methods,prognosis,etc.Results:There were 25 males and 14 females with an average age of(56.13±7.94)years(ranging from 42 to 70 years).There were 21 smokers(53.8%).The first clinical symptoms were cough and sputum in 21 cases(53.8%),hemoptysis in 5 cases(12.8%),chest tightness in 5 cases(12.8%),and fever in 3 cases(7.7%).Five cases(12.8%)were found to be asymptomatic during physical examination.Pulmonary underlying diseases included 12 cases(30.8%)of chronic obstructive pulmonary disease,4 cases(10.3%)of bronchial asthma,4 cases(10.3%)of bronchiectasis,1 case(2.6%)of interstitial lung disease,1 case(2.6%)of pulmonary tuberculosis,and 17 cases(43.6%)without pulmonary underlying diseases.Chest CT showed smooth and clearly defined masses within the bronchi(such as circular or lobulated masses),atelectasis,obstructive pneumonia,pleural effusion,and other manifestations.The final patients were diagnosed with PMEC through pathology and the possibility of salivary gland metastasis was ruled out.The pathological manifestations were 28 cases of low-grade and 11 cases of high-grade.Compared with high-grade patients,the overall survival(OS)of low-grade patients was significantly better(P=0.000).Compared with the non-surgical treatment group,the OS rate of patients in the surgery based comprehensive treatment group was significantly better(P=0.001).Conclusion:The clinical symptoms and chest CT manifestations of primary PMEC are diverse and lack specificity,and diagnosis requires histopathology.Surgery is the preferred treatment method.The results of multivariate analysis showed that histological grading is the most important and reliable prognostic indicator.
作者
王梦歌
欧阳松云
刘艳君
WANG Mengge;OUYANG Songyun;LIU Yanjun(Department of Respiratory and Sleep Disease,the First Affiliated Hospital of Zhengzhou University,Henan Zhengzhou 450000,China)
出处
《现代肿瘤医学》
2025年第10期1692-1697,共6页
Journal of Modern Oncology
基金
国家自然科学基金资助项目(编号:U1804195)。
关键词
原发性肺黏液表皮样癌
临床表现
预后
生存分析
primary pulmonary mucoepidermoid carcinoma
clinical manifestation
prognosis
survival analysis
