91例细支气管肺泡细胞癌的外科治疗分析

Surgical treatment of 91 cases with bronchioloalveolar carcinoma

目的 评价支气管肺泡细胞癌的发病率、诊断方法及治疗效果。方法 自 1977年 1月至1995年 10月手术治疗术后病理证实的细支气管肺泡细胞癌 91例。回顾性分析了发病率、组织发生、临床特点、影像学表现以及治疗与预后。结果 91例支气管肺泡细胞癌占同期肺癌的 2 34 % (91 3882例 ) ,占同期肺腺癌的 11 0 4% (91 82 4例 )。不吸烟者占 6 8 13%。全组手术切除率为 96 7% (88 91例 )。I期 6 2例 (IA 期 37例 ,IB 期 2 5例 )、II期 10例 (IIA 期 3例 ,IIB 期 7例 )、III期 9例 (IIIA 期 8例 ,IIIB 期 1例 )、IV期 10例。孤立结节型 6 7例 ,弥漫型 8例 ,肺炎型 16例。X线胸片可见明显的空泡征 2 9 7% (2 7 91例 )和细支气管充气征 13 2 % (12 91例 ) ,占直径小于 3cm孤立结节型病灶的 39 0 % (16 41例 )和2 1 9% (9 41例 ) ;胸膜凹陷征占孤立结节型的 31 3% (2 1 6 7例 )。全组 3年及 5年生存率分别为 5 2 32 %和 35 46 % (I期 6 2 91%、45 16 % ,II期 40 0 0 %、2 0 0 0 % ,III期 11 11%、0 ,IV期 10 %、0 ;中心型为13 6 3%、4 5 4% ,周围型 5 3 6 3%、37 6 8% ;孤立结节型 5 3 74%、37 32 % ,弥漫型 12 5 0 %、0 ,肺炎型18 75 %、12 5 0 % )。结论 细支气管肺泡癌是一种特殊类型腺癌 ,女性?

Objective: To evaluate the incidence, diagnosis and therapeutic results of bronchioloalveoar carcinoma. Methods: Since January 1977 to October 1995, 91 patients with bronchioloalveolar carcinoma were treated surgically. The incidence rate, features of histology, characteristics of radiology, as well as the result of treatment and prognosis were studied retrospectively. Results: All patients were proved pathologically of bronchioloalveolar carcinoma. Nonsmokers accounted for 68 13%. The resectability rate in our group was 96 7%(88/91). Stage I was in 62 cases(IA 37, IB 25), stage II in 10 (IIA 3, IIB 7),stage III in 9(IIIA 8 ,IIIB 1), and stage IV in 10.The solitary nodule type was in 67 cases, diffuse type in 8, and pneumonics in 16. The overall cumulative survival at 3 and 5 years was 52 32% and 35 46%, respectively (stage I 62 91% and 45 16%, stage II 40% and 20%, stageIII 11.11% and 0, stage IV 10% and 0; the central type was 13 63% and 4 54%, the peripheral 53 63% and 37 68%; the solitary nodule type was 53 74% and 37 32%, the diffuse type was 12 5% and 0, the pneumonia 18 75% and 12 5%). Conclusion: Bronchioalveoar carcinoma is a special form of adenocarcinoma. Its incidence rate has increased in recent years. And the female accounts for most of the cases. No obvious relation is found with smoking. It has its own characteristics either on histology or radiology. Solitary nodule type has high resectability rate and better prognosis.