细支气管肺泡癌77例临床分析

目的 探讨细支气管肺泡癌的临床症状、诊断、误诊、病理类型、影像学特点、治疗方案及预后.方法 回顾性分析解放军总医院2003年1月至2007年12月期间住院治疗的经病理证实的77例细支气管肺泡癌病例.结果本 组病例占我院同期住院治疗的原发性支气管肺癌患者的4.6%(77/1 665),男女比例为1.66:1;对53例资料完整病例进行统计学分析,中位生存期47.4个月;吸烟、治疗方案的组间生存曲线差异有显著意义(P<0.05).结论 细支气管肺泡癌患者临床表现多样.缺乏特征,咳大量泡沫样痰的症状并不多见.再加上影像学上的多样性.易被溟诊;对细支气管肺泡癌的治疗应采用手术为主,结合化疗、放疗、分子靶向治疗的综合治疗方式;对晚期不能手术的患者采用先化疗后分子靶向治疗的续贯疗法可取得较好的疗效.

Clinical analysis of 77 patients with bronchioloalveolar carcinoma

Objective To investigate the clinical symptom, diagnosis, misdiagnosis, pathological and radiologieal characteristics,treatment regimen and prognosis of bronchioloalveolar earcinoma(BAC). Methods The clinical data of 77 BAC patients who were admitted in PLA general hospital were retrospectively analyzed. Results The enrolled cases in this study accounted for 4.6% (77/1 665) of patients with primary bronchiogenic carcinoma who were admitted in PLA general hospital during the same period. The ratio of male patients to female patients was 1.66 : 1. The median survival time was 47.4 months. The survival was correlated with smoking and treatment regimen. Conclusions Bronchorrhea is not commonly seen in BAC. Because of the radiological diversity and atypical clinical symptom, BAC may be misdiagnosed. Surgery remains the primary treatment method,supplemented by chemotherapy, radiotherapy and molecular targeted therapy. For patients who are inoperable and in the advanced stage,chemotherapy combined with molecular targeted therapy can have better therapeutic effect.