肺炎型肺癌的诊治体会(附10例报道)

Diagnosis and Treatment of Pneumonic-type Lung Carcinoma ( Report of 10 Cases)

目的:探讨肺炎型肺癌(PTLC)的临床特点及诊断和治疗。方法:回顾性分析我院2004年3月至2009年10月期间收治的10例PTLC患者的临床资料,对其诊断和治疗进行分析。结果:PTLC缺乏特异性临床表现,影像学表现为大片状实变伴"空气支气管征"、"空泡征"及小结节等,确诊需有病理学结果。10例患者均行手术治疗,行根治性手术7例,其中肺叶切除4例,联合肺叶切除1例,一侧肺切除2例,3例患者因肿瘤广泛转移而仅行剖胸活检术。围手术期无死亡和严重并发症发生。术后辅以化疗或放疗。经4个月～60个月随访,其中3例丧失手术机会者于术后1年内全部死于呼吸衰竭,7例患者生存期为15个月～52个月(平均31个月)。结论:PTLC早期诊断需结合临床表现和影像学检查,病理学检查可确诊。手术是治疗的主要手段。

Objective： To explore the diagnosis and treatment of pneumonic-type lung carcinoma （PTLC）. Methods： The clinical data of 10 patients with PTLC were retrospectively collected. The diagnosis and treatment were analyzed. Results： The patients with PTLC lacked typical clinical manifestations. The characteristic imaging findings included massive consolidation accompanied with air bronchogram, vacuole sign and small nodules. Pathologic finding was indispensable to diagnosis. Surgery was performed in all patients. Seven patients underwent radical operation including pulmonary lobectomy in 4 cases, bilobectomy in one case and lobectomy in two cases, the rest 3 cases only received biopsy through thoracotomy due to extensive metastasis. No one died and no serious complication happened during operation. The patients received chemotherapy or radiotherapy after operation. After the follow-up of 3 - 60 months, 3 cases who could not be radically resected died of respiratory failure after one year of operation and 7 cases survived from 15 to 52 months （mean 31 months）. Conclusion： Early diagnosis of PTLC depends on clinical manifestation and imaging examination. Pathological examination is used to confirm the diagnosis. Surgery is the main method to cure this disease.