24例细支气管肺泡细胞癌外科治疗效果

目的总结细支气管肺泡细胞癌（BAC）的临床特点及外科治疗效果。方法回顾性分析我院2000年1月至2006年12月经手术治疗的24例BAC的临床资料，并随访其生存情况。结果本组男性11例（46％），女性13例（54％），平均年龄59．1（47～72）岁；其中孤立结节型13例，肺炎实变型7例和多发结节型4例。全组均手术切除。术后TNM分期：Ⅰ期8例（ⅠA期4例、ⅠB期4例），Ⅱ期4例（ⅡA期1例、ⅡB期3例），Ⅲ期11例（ⅢA期7例、ⅢB期4例），Ⅳ期1例。随访22例，平均随访时间42月（12月～90月）；10例死亡，死亡者术后中位生存期14月。结论BAC是一种特殊类型腺癌，呈女性多发趋势。早期BAC的手术治疗可以取得满意的长期生存，没有淋巴结转移的多发结节型BAC仍可采取手术治疗，肺炎实变型BAC手术治疗效果差。

An analysis of surgical treatment and outcome in 24 cases with bronchioloalveolar carcinoma

Objective To summarize the clinical features of brenchioloalveolar carcinoma （BAC） and the therapeutic results of surgical treatment on them. Methods The clinical data of 24 cases of BAC which had operation from Jan. 2000 to Dec. 2006 in our hospital were retrospectively analyzed and followed up. Results Among 24 cases of BAC, 11 were men（46 % ） and 13 were women（ 54% ）, with a mean age of 59. 1 years （range,47 to 72years）, There were 3 types of BAC, in which 13 cases were of solitary nodule, 7 cases were consolidation or pneumonic mass, and 4 cases were of multiple nodules in the same lung. All patients were resected. There were 8 cases diagnosed postoperatively as stage Ⅰ （ Ⅰ A4, Ⅰ B4）, 4 cases as stage Ⅱ （ Ⅱ A 1, Ⅱ B3 ）, 11 cases as stage Ⅲ （ ⅢA7, ⅢB4 ）, and 1 case as stage IV. 22 cases were followed up with the mean period of 42 months （range, 12 to 90 months）. 10 patients died, of whom the median survival time was 14 months. Conclusion BAC is a special form of adenocarcinoma, and the female accounts for most of the cases. Those patients with localized, early - stage BAC who underwent curative surgery had a better survival. Surgery should not to be denied also in patients with multiple nodules in the same lung, when no lymph node involvement. The type of consolidation or pneumonic mass had a worse prognosis relatively.