10例肺炎型肺癌的诊治体会

The Experience of Diagnosis and Treatment of 10 Cases With Pneumonic-tupe Lung Cancer

目的探讨肺炎型肺癌的临床特征,提高认识,减少误诊。方法分析10例肺炎型肺癌患者的临床表现、影像学表现及诊治过程。结果肺炎型肺癌临床可表现为发热,咳嗽,咳痰,呼吸困难;胸部CT表现为大片状模糊阴影;抗感染、抗结核治疗无效。经3~38个月随访,其中有8例患者1年内均死于呼吸衰竭,1例患者生存期长达30个月(口服分子靶向药物),1例术后患者目前身体状态好,无复发和转移。肺炎型肺癌病理类型以腺癌为主,发现时大部分发展为晚期,治疗以化疗和分子靶向治疗为主,如有EGFR基因突变,生存期可达30个月以上。结论肺炎型肺癌极易误诊为肺炎,临床医生应该提高对本病的认识。

Objective To investigate the clinical manifestations of pneumonic-type lung carcinoma,in order to improve the understanding of the clinical features of pneumonic-type lung carcinoma and decrease the rate of misdiagnosis.Methods The clinical manifestation,the imaging characteristics,the process of diagnosis and treatment of the ten cases pneumonia styled lung cancer were reviewed and analyzed.Results Clinical manifestation of pneumonia styled lung cancer goes like:fever,exspectoration,dyspnea;thoracic CT showing big blurred shadow;anti-infection and anti-tuberculosis treatment was useless.After 3 to 38 months,8 patients died of respiratory failure in 1 years,1 patients had a survival period of up to 30 months(oral molecular targeting drugs),and 1 patients was now in good physical condition without recurrence and metastasis.The pathological types of lung cancer are mainly adenocarcinoma,and most of them develop late,the treatment is mainly chemotherapy and molecular targeted therapy,and if EGFR gene mutation,the survival period can reach more than 30 months.Conclusion It is extremely possible to diagnose pneumonia styled lung cancer as pneumonia,and clinicians should enhance kownledge of this disease.