原发性23例肺黏液表皮样癌临床病理分析

Clinicopathological analysis of 23 cases of primary pulmonary mucoepidermoid carcinoma

目的探讨肺黏液表皮样癌(pulmonary mucoepidermoid carcinoma,PMEC)的临床病理特征,为临床诊断及治疗提供参考。方法回顾性分析南京医科大学附属无锡市人民医院2009年1月至2021年12月经病理证实或免疫组织化学辅助下证实的23例PMEC患者的临床病理资料和随访资料,对其临床病理特征、治疗及预后进行分析。结果根据组织学分级,将所有患者分为低级别组(n=15)和高级别组(n=8)。癌胚抗原(carcinoembryonic antigen,CEA)升高(P=0.002)、有吸烟史(P=0.039)、TNM分期高(P=0.001)和淋巴结转移(P<0.01)的患者中高级别PMEC占比更高。单因素分析显示,PMEC患者的总生存期在组织学分级(P=0.020)、淋巴结转移(P=0.002)和TNM分期(P=0.040)方面比较,差异均具有统计学意义。多因素分析显示淋巴结转移是PMEC患者总生存的独立预后因素(P<0.01)。结论PMEC发病率低,患者的预后与组织学分级、淋巴结转移及TNM分期有关,且淋巴结转移是其预后的独立危险因素。

Objective To investigate the clinicopathologic features of pulmonary mucoepidermoid carcinoma(PMEC),and to provide reference for clinical diagnosis and treatment.Methods The clinicopathological data and follow-up data of 23 PMEC patients confirmed by pathology or immunohistochemistry in Wuxi People's Hospital Affiliated to Nanjing Medical University from January 2009 to December 2021 were retrospectively analyzed,and the clinicopathological characteristics,treatment and prognosis were analyzed.Results According to histological grading,all patients were divided into the low grade group(n=15)and high grade group(n=8).Patients with elevated carc-inoembryonic antigen(CEA)(P=0.002),smoking history(P=0.039),high TNM stage(P=0.001)and lymph node metastasis(P<0.01)had higher proportions of high-grade PMEC.Univariate analysis showed that the overall survival of PMEC patients was statistically significant in terms of histological grade(P=0.020),lymph node metastasis(P=0.002)and TNM stage(P=0.040).Multivariate analysis showed that lymph node metastasis was an independent prognostic factor for the overall survival of PMEC patients(P<0.01).Conclusions The inci-dence rate of PMEC is low.The prognosis of PMEC is related to histological grade,lymph node metastasis and TNM stage,and lymph node metastasis is an independent risk factor for its prognosis.