19例肺腺鳞癌的影像诊断与病理分析

Image Diagnosis and Pathological Analysis on 19 Cases of Adenosquamous Carcinoma of Lung

目的:探讨肺腺鳞癌的影像表现与病理学的关系．方法:收集10年来内蒙古民族大学附属医院经手术切除及病理证实的19例肺腺鳞癌患者的胸片及CT检查结果．19例有胸片,9例行胸部CT检查．结果:手术治疗8例,取出36个淋巴结均阳性．放、化疗11例．在镜下按两种肿瘤的任何一种必须占全部肿瘤的20％以上的标准诊断．本组按瘤内腺癌含量<40％,40％～60％,>60％分3组,结果<40％6例,40％～60％8例, >60％5例．影像学表现为周围型10例,中央型9例．单发18例,多发1例,9例中央型腺鳞癌合并肺不张大小平均4．50～6．60 cm,10例周围型腺鳞癌肿块大小平均4．10～5．10 cm．结论:据报道发病率大约占10％, 发病率与分型标准、取材多少有关．认为瘤内腺癌成份与影像学所表现的肿瘤分型、部位、形态、大小、边缘、密度无明显的关系．

Objective： To discuss the relationship between image appearance and pathological findings on adenosquamous carcinoma of lung. Methods：19 cases （male 17, female 2, aged from 38 to 70） of adenosquamous carcinoma of lung which received surgical removal and were confirmed pathologically had been collected in our hospital during the past 10 years. Main symptoms：cough, sputum with blood, chest pain, short breath, fever and pantalgia. Main body signs：enlargement of supraclavicular lymph nodes, metastatic carcinoma of bone and hydrothorax. All 19 cases had X- ray chest films and 9 cases received chest CT examinations. Results：8 cases received surgical treatment and 36 lymph nodes were removed which were all positive. 11 cases were given radiotherapy and chemotherapy. Under the microscope, the diagnostic standard is that either of two kinds of tumors must make up 20 % of all the tumors. 3 groups were divided based on the fact that the proportion of adenocarcinoma in adenosquamous carcinoma, acounting for less than 40 96 （6 cases）,40 % - 60 % （8 cases）, more than 60 % （5 cases）. Imageologic appearance indicated 10 cases were peripheral type,and 9 cases central type. 18 cases were single type and 1 case multiple type. The average size of tumor mass in 8 cases of central - type with pulmonary atelectasis was 4.50-6.60 cm and 4.10-5.10 cm in 10 cases of peripheral type. Conclusion ： It is reported that it is about 10 % for incidence of adenosquamous carcinoma of lung. The incidence is related to typing standard and the materials drawn. It is believed that there is no significant relationship among the proportion of adenocarcinoma and the tumor typing, position, appearance, size, margin, and density shown in imageology.