胃癌合并肺淋巴管癌病7例的临床病理特征分析

Clinical characteristics of gastric cancer with pulmonary lymphangitic carcinomatosis in seven cases

目的分析胃癌致肺淋巴管癌病患者的临床资料、病理特征以及随访资料。方法回顾性分析2000年1月至2017年12月期间北京大学人民医院诊治的胃癌合并肺淋巴管癌病的7例患者。结果本组7例患者均为女性，平均年龄（54±18）岁。4例以呼吸道症状就诊，3例以消化道症状就诊。1例患者行胃切除术，1例患者行化疗。5例合并其他部位转移，1例患者仍存活，自症状出现后的平均生存时间为（4．8±4．0）个月。结论胃癌所致肺淋巴管癌病的临床表现多以呼吸道症状为主，胸部高分辨CT提示双肺间质和小叶间隔弥漫性结节状增厚。胃活检病理多见于低分化腺癌和印戒细胞癌，预后极差。

Objective To summarize and analyze the clinical characteristics, pathological features and follow-up data of patients with pulmonary lymphangitic carcinomatosis （PLC） caused by gastric cancer. Methods A retrospective analysis was performed on 7 cases of gastric cancer with pulmonary carcinomatosis in Peking University People＇s Hospital between Jan 2000 and Dec 2017. Results 7 patients were identified from our database. All patients were female, with an average age of （54 _± 18） years. 4 patients were treated with respiratory symptoms and 3 patients presented with gastrointestinal symptoms. One patient received gastrectomy, one did chemotherapy, 5 patients had other site metastasis, one was still alive at the end of follow up. Patients average survival time was （4.8±4.0） months. Conclusions Pulmonary lymphatic carcinomatosis caused by gastric cancer is rare clinical entity and the prognosis is poor. Patients often present with respiratory symptoms. Chest CT showed diffusely nodular thickening of interlobular septa and peribronchovascular interstitium. Biopsy of the gastric tumor often establish the diagnosis.