结节病——一种需要与肺癌鉴别的疾病

Sarcoidosis-A Disease Needs to Be Differentiated from Lung Cancer

结节病是一种非干酪样坏死类上皮样结节与肉芽肿性炎症并存的病变,可累及全身,但90%以上累及胸部,常与肺癌等疾病相混淆。因此,胸外科医师对结节病须有清醒的认识,同时由于手术取材的特殊作用,胸外科医师在结节病的诊治中起重要作用。具有典型临床特征的结节病不难诊断,然而多数患者表现缺乏特异性。结节病的病因尚未明确,治疗亦无特效方案,但近期研究显示膜联蛋白A11基因可能与结节病发病相关,肿瘤坏死因子(TNF)抑制剂在结节病的治疗中具有一定效果。

Sarcoidosis isa common systemic disease with noncaseating granulomatous epithelioid nodule and coexisting granulomatous inflammation.Although sarcoidosis can affect any organ of the body,morethan90%of the patients demonstrate thoracic involvement,which is often confusingwithlung cancer and otherdiseases.Therefore,thoracic surgeons must have a clear understanding of sarcoidosis.Moreover,due to the special role of surgery in obtaining pathological specimens,thoracic surgeon plays an important role in the diagnosis and treatment of sarcoidosis.It is not difficult to make diagnosis for patients with typical clinical features of sarcoidosis.However,the majority of patients do not have specific manifestations of sarcoidosis.The cause of sarcoidosis remains unknown,and there is also no specific treatment strategy for it.But recent research has shown that annexin A11 gene may be involved in the pathogenesis of sarcoidosis,and tumor necrosis factor（TNF） inhibitor is effective in the treatwent of sarcoidosis.