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目的探讨肺多形性癌(pleomorphic carcinoma,PC)的临床表现、手术方式、病理特点及预后。方法回顾性分析我院胸外科2010年1月~2014年3月收治的23例肺多形性癌患者的临床及病理资料。结果 23例患者发病年龄为35~75岁,平均年龄(54±11)岁,其中男16例,女7例,男女比为2.3:1。17例患者有既往大量吸烟史,吸烟指数为400~1200,平均(688±225)。患者常见首发症状为咳嗽、痰中带血或咯血。术前纤维支气管镜检查难以确诊。23例患者中行肺癌根治术22例,行肿块活检术1例。23例患者中含有恶性上皮成分和多形性成分19例,4例仅含多形性成分,多形性成分中可见CK阳性表达。23例患者均获得随访,最长生存时间为18个月,仍存活,中位生存期12个月。结论肺多形性癌好发于中老年男性吸烟患者,免疫组织化学检查有助于明确诊断,外科手术为主要治疗方法。肺多形性癌预后差。
Objective To investigate the clinical manifestations, surgical modalities, pathological features and prognosis of pleomorphic carcinoma (PC). Methods The clinical and pathological data of 23 patients with pleomorphic lung cancer admitted to our hospital from January 2010 to March 2014 were retrospectively analyzed. Results The onset age of 23 patients was 35-75 years, with an average age of (54 ± 11) years, including 16 males and 7 females, with a ratio of men to women of 2.3: 1.17 patients had a history of heavy smoking and a smoking index of 400 ~ 1200, average (688 ± 225). The first common symptom in patients is cough, bloody sputum or hemoptysis. Preoperative bronchoscopy is difficult to diagnose. Twenty-three patients underwent radical mastectomy for lung cancer and one patient underwent biopsy. Of the 23 patients, 19 had malignant epithelium and pleomorphic components, 4 had only pleomorphic components, and CK showed positive expression in pleomorphic components. Twenty-three patients were followed up for a maximum of 18 months and survived for a median of 12 months. Conclusions Pulmonary pleomorphic cancer occurs in middle-aged and elderly male patients with smoking. Immunohistochemical examination is helpful to confirm the diagnosis and surgery as the main treatment. Prognosis of lung pleomorphic cancer is poor.