31例肺黏液表皮样癌的临床分析及文献复习

Clinical analysis and literature review of 31 cases of pulmonary mucoepidermoid carcinoma

目的探讨肺黏液表皮样癌(PMEC)的临床表现、病理特征及预后影响因素。方法回顾性分析郑州大学第一附属医院2012年5月至2017年5月收治的31例肺黏液表皮样癌的临床资料.并对其预后影响因素进行分析。结果本研究31例患者中男17例,女14例;年龄(52.16+17.51)岁,年龄范围为5~78岁;肺部占位以左肺上叶最多见;诊断中15例经肺穿刺活检确诊,14例经气管镜确诊.2例经手术后标本确诊.31例PMEC中1例合并腺鳞癌;高级别PMEC 15例.低级别PMEC 16例;手术治疗11例,未行手术治疗20例;随访时间5~72个月;全部患者1年、3年、5年的生存率分别为87.1%. 45.2%、6.5%,中位生存期26个月。结论 PMEC是?种罕见的肺部恶性肿瘤.其临床表现缺乏特异性.主要表现为呼吸道刺激及阻塞症状;确诊依靠穿刺活检、气管镜或手术组织病理.辅以免疫组织化学分析;治疗以手术为主,辅以化疗及靶向治疗。病理学组织分级、TNM分期、手术是影响PMEC预后的重要因素。

Objective To discuss the clinical manifestation, pathological features and prognostic factors of pulmonary mucoepidermoid carcinoma (PMEC). Methods The clinical data of 31 cases of PMEC admitted to the First Affiliated I lospital of Zhengzhou University from May 2012 to May 2017 was retrospectively analyzed, its prognostic factors were also analyzed. Results There were 31 patients in this study, including 17 males and 14 females, age is ( 52.16±17. 15 ) years (range from 5 to 78 years). The pulmonary shadow was most common in the left upper lobe. 15 cases were diagnosed by lung biopsy, 14 cases were diagnosed by bronchoscopy, and two cases were confirmed by operation.()ne case was diagnosed as PMEC combined adenosquamous carcinoma in the 31 cases. There were 15 patients identified as high-grade PMEC and 16 patients identified aslowgrade PMEC. 11 cases were underwent surgery treatment, 20 cases were non-operatived treatment. The follow-up time was 5 ?72 months. The overall 1-, 3-, 5-year survival rates were 87.1%,45.2 %, 6.5 % respectively. The median survival time was 26 months. Conclusions PMEC is a rare malignant tumor of the lung, lacking specific clinical characterization, which mainly characterized as respiratory tract irritation and obstruction symptoms. PMEC can be diagnosed mainly depends on biopsy, bronchoscopy or histopathology, supplemented by immunohistochemical analysis. Surgery is the main treatment method, chemotherapy and molecular targeting therapy are also needed. The prognosis of PMEC relates topathological types, TNM stage and surgery treatment.