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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 investigate the clinical features and therapeutic effects of bronchioloalveolar carcinoma (BAC) and to improve the early diagnosis of bronchioloalveolar carcinoma and achieve the purpose of timely treatment. Methods The clinical and pathological data of 21 BAC patients admitted from 2005 to 2010 in the Second Affiliated Hospital of Hygeiae Biyoung were retrospectively analyzed. Results Most of the patients had cough, hemoptysis or sputum with blood in the clinic, followed by chest pain and dyspnea. Imaging examination mainly manifested as solitary nodules, multiple nodules and infiltrating pneumonia, and the single nodules were the most , 11 cases, accounting for 52.4% of the total. Only 7 cases were diagnosed at the first visit, with a misdiagnosis rate of 66.7% (14/21). No tumor cells were found in sputum culture examination and fiberoptic bronchoscopy. The time for misdiagnosis was 1 to 18 months in the hospital. Among them, 15 cases underwent lobectomy and lymphadenectomy by surgery, 10 cases received chemotherapy, 4 cases did not receive any treatment, 21 cases were confirmed by histopathology as bronchioloalveolar carcinoma, and can not confirm the smoking and bronchioloalveolar alveoli There is no clear correlation between the occurrence of cancer. Conclusions Bronchial alveolar carcinoma is easy to be misdiagnosed and the radiological findings are special. The single nodular surgical treatment is effective. Patients who can not be diagnosed timely should be further related to reduce the misdiagnosis, to reach the advanced lung cancer patients and can not Patients tolerated by surgery are eligible for chemotherapy.