肺原发性黏液表皮样癌的临床病理研究

The Clinicopathologic Study of Pulmonary Primary Mucoepidermoid Carcinoma

[目的]分析肺原发性黏液表皮样癌的临床病理特征,并探讨其诊断标准及预后。[方法]对31例肺原发黏液表皮样癌进行临床病理分析并复习相关文献。[结果]31例黏液表皮样癌患者中,低级别者13例,高级别者18例。患者多表现为咳嗽及痰中带血,偶有胸痛、胸闷和发热等症状。其中单纯肺楔形切除2例,单纯部分肺叶切除7例,部分肺叶切除+淋巴结清扫术14例,单侧全肺叶切除2例,6例无手术适应证。低级别和高级别患者手术后3年和5年生存率分别是100%、100%和63.6%、54.5%。[结论]肺原发性黏液表皮样癌是肺部少见的恶性肿瘤。组织形态学及生物学行为与涎腺的黏液表皮样癌相似。确诊主要靠组织病理学,并辅以免疫组化标记。此类型肿瘤生长缓慢,手术易切除,预后较好。

[Purpose] To investigate the clinical pathological features of pulmonary primary mucoepidermoid carcinoma and to discuss its diagnostic criteria and prognosis. [Methods] The clinical and the pathological characteristics of pulmonary primary mucoepidermoid carcinoma were analyzed and related literatures were reviewed. [Results] The 31 cases showed 13 cases with low-grade and 18 cases with high-grade. Cough and bloody sputum were main symptoms,while chest pain,chest distress and fever were less seen. There were 2 cases performed with simple wedge resection,7 cases performed with simple partial pulmonary lobectomy,14 cases performed with simple partial pulmonary lobectomy and lymph node dissection,2 cases performed with unilateral total lobectomy and 6 case performed without operation. The 3- and 5- year overall survival（OS） of low-grade and high-grade were 100%,100% and 63.6%,54.5%,respectively. [Conclusion]Mueoepidermoid carcinoma of the lung is a very rare primary tumor.The morphology of this lung tumor is similar to its counterpart in the salivary gland.Definite diagnosis should be mainly based on pathological examination in assistance with immunohistochemical analysis. The tumor grows slowly,and has complete excision of the operation and has an excellent prognosis.