细支气管-肺泡癌47例分析

Clinical Analysis of Patients with Bronchiolo-Alveolar Carcinoma

报道47例细支气管-肺泡癌的特征。多发于54岁左右的中年人,性别无明显差异。临床表现主要为咳嗽、咯痰、咯血、低热、胸痛。X线分为局灶型和弥漫型两种,局灶型以周围型结节占绝大多数(73.5％),肺炎型占局灶型的26.5％。弥漫型中以混合型居多占76.9％,特征为双肺弥漫分布的网结节状或粟粒状阴影;其次为肺间质纤维化和多发结节型。对肺炎型和弥漫型应尽早行纤支镜取材活检,对诊断有重要价值,对弥漫型诊断阳性率达88.9％。局灶型以手术切除为主,切除率达93.8％。弥漫型以化疗为主。

Forty-seven cases with bronchiolo-alveolar carcinoma (BAC) were reported. The disease frequently occurred in ≥54 years old men and women. The prominant symptoms were cough with sputum, hemoptysis and chest pain. In chest film,BAC could be divided into 2 types:limited and diffused. Solitary nodular(73. 5%) was the main form of limited type,pneumonia form was 26. 5% .mixed form was 76. 9% of diffused type, which shared complicated reticulonodular or miliary nodular diffusedly distributed in middle and lower lung zones. Pulmonary interstitial fibrosis and multiple nodular were the other two forms of diffused BAC. The sensitivity of transbronchial lung biopsy (TBLB) was 88. 9% in diffused BAC 93. 8% of limited BAC could be surgically resected,and chemical therapy was the main treatment of diffused BAC.