肺肉瘤样癌14例临床分析

Clinical analysis of sarcomatoid carcinoma of the lung

背景与目的肉瘤样癌(sarcomatoidcarcinoma,SC)是一种较少见的癌和肉瘤样形态混合于一个瘤体内的恶性肿瘤。本观察拟探讨肺肉瘤样癌的临床、病理特点。方法回顾性分析14例经组织病理学证实的肺肉瘤样癌的临床表现、病理特点、治疗经过并进行随访。结果肺肉瘤样癌发病平均年龄为62岁,男女之比为6比1,临床表现与其他类型肺癌相似。其增强CT有一定特征性,但纤维支气管镜检查难以明确诊断,免疫组化均有上皮表型。结论肺肉瘤样癌的诊断主要依靠手术病理,不能行手术者可能漏诊,免疫组化对其诊断及鉴别诊断很有帮助。治疗策略与非小细胞肺癌相似。

Background and objective Sarcomatoid carcinoma （SC） is a rare malignant cancer with mixed tumor and sarcomatoid tissues. The aim of this study is to investigate the clinical manifestations and pathological findings of sarcomatoid carcinoma of the lung. Methods Data including clinical manifestations, pathological findings, treatment were retrospectively analysed from fourteen patients with lung sarcomatoid carcinoma confirmed by pathology and follow-up was carried out. Results Mean age at onset was 62 years old and gender ratios （M/F） in these patients was 6 ： 1. The clinical manifestations of lung sarcomatoid carcinoma were similar to that of other types of lung cancer while there were characteristic findings on the enhancement CT scan. Bronchofiberscopy was not a reliable examination for final diagnosis. Cells with endothelial phenotype could be detected by immunohistochemical method. Conclusion The final diagnosis of this disease depends on histopathological observation, while the diagnosis may be missed among patients without surgical intervention. Immunohistochemical examination is helpful for diagnosis and differential diagnosis. The therapeutic strategy is coincident with that for non-small cell lung cancer.