无症状肺癌纤维支气管镜下表现及病理特征分析

Retrospective analysis of fibrobronchoscopy for patients with asymptomatic lung cancer

目的探讨无症状肺癌患者的纤维支气管镜检及病理特征。方法以1981年3月～2007年5月期间在该院通过纤维支气管镜活检并行病理学检查而明确诊断为无症状性肺癌患者70例作为研究对象,根据上述患者的构成特点对其病变部位、纤维支气管镜下表现及病理分型情况进行回顾性分析。结果男性64例,平均年龄(57.89±12.06)岁;女性6例,平均年龄(52.83±8.33)岁。上述患者解剖学分类以中央型肺癌为主,以双肺上叶出现病变的患者最多,其次为右肺中叶,而双肺下叶较少。患者镜下表现以腔内新生物堵塞、黏膜肥厚、凹凸或肿胀为主。无吸烟史及吸烟指数大于400支/年的男性患者中,其病理类型以鳞癌为主,其次为小细胞未分化癌;而吸烟指数小于400支/年的男性患者中,其病理类型以腺癌为主,其次为鳞癌。女性患者中无鳞癌发生,而以腺癌及小细胞未分化癌为主。结论早期中央型肺癌尤其发生在双肺上叶者亦可能无明显临床症状。

[Objective] To explore the pathological and bronchoscopic characteristics of patients with asymptomatic lung cancer. [Methods] Retrospective analysis was done on the diseased region, pathological and bronchoscopic characteristics of the 70 cases with asymptomatic lung cancer. [Results] There were 64 males and 6 females in the study, and most of them had central tumors. Furthermore, the diseased were mainly located in pulmones superior lobes and middle lobe of right lung, and the frequency in pulmones lower lobes is very low. The main features of fibrobronchoscopy were neoplasm, engorgement and rough in mucosa. Both symptoms were found in male heavy smokers （cigarette smoking index ≥ 400） and nonsmoker. Squamous carcinoma was the No.1 type, and the next was small cell undifferentiated carcinoma; But in male moderate and mild smoker （cigarette smoking index〈400）, adenocareinoma was the main type, and the next was squamous carcinoma. In female cases, the major types were adenocareinoma and small cell undifferentiated carcinoma. [Conclusions] The earlier central type of lung cancer located in pulmones superior lobes is probably asymptomatic.