肺NUT癌的临床特征及CT影像学分析

Clinical Characteristics and CT Imaging Analysis of Lung NUT Cancer

目的 分析11例原发性肺NUT基因相关性癌(NUT癌)临床特征及CT影像学表现。方法回顾性分析2016年1月至2023年10月空军军医大学附属唐都医院经免疫组化病理证实的11例肺NUT癌患者。男9例、女2例,年龄30-65岁,中位年龄51岁。收集患者临床信息、病理特点及影像资料,并对患者进行电话随访了解其治疗史及预后情况。结果肿块位于右肺5例,左肺5例,1例位于气管腔内。11例患者肺内病变均为分叶状生长,最大径线2.5cm~11.5cm,平均最大径线为5.5cm;6例病变CT平扫密度均匀,5例病变密度不均匀,8例患者行增强扫描所示肿块呈轻度强化。10例发生转移,其中纵隔及肺门淋巴结转移9例,肺内转移4例(同侧肺转移3例,双侧肺内转移1例),骨转移4例(3例溶骨性转移,1例成骨性转移),肝转移1例。11例免疫组化NUT均为阳性。5例患者死亡,其中3例患者未治疗,发病2月后出现多器官衰竭死亡,1例患者行化疗及肺叶切除术后2月死亡,1例患者行肺叶切除术后2月死亡。6例存活患者在治疗后随访时间1-33月。结论 NUT癌是一种肺少见的基因相关恶性实休肿瘤,双肺均可发生,表现为分叶状肿块,休积较大,密度均匀或不均匀,增强扫描呈轻度强化,常伴有肺门及纵隔内多发淋巴结转移,较容易发生远处转移。接受早期治疗后,可延长生存时间。

Objective To analyze the clinical features and CT imaging findings of 11 cases of primary lung NUT gene related carcinoma(NUT carcinoma).Methods A retrospective analysis was conducted on 11 patients with lung NUT ca ncer confirmed by immunohistochemist ry and pathology at Ta ngdu Hospital affiliated to Air Force Military Medical University from January 2016 to October 2023.There were 9 males and2 females,aged 30-65 years,with a median age of 51 years.Collect clinical information,pathological characteristics,and imaging data of patients,and conduct telephone follow-up to understand their treatment history and prognosis.Results The mass was located in 5 cases in the right lung,5 cases in the left lung,and 1 case in the airway.The pulmonary lesions in all 11 patients showed lobular growt h,with a maximum diameter of 2.5cm~11.5cm and an average maximum diameter of 5.5cm;Six lesions had uniform density on plain CT sca ns,five lesions had uneven density,and eight patients showed mild enhancement of the mass on contrast-enhanced sca ns.There were 10 cases of metastasis,including 9cases of mediastinal and hila r lymph node metastasis,4 cases of intrapulmonary metastasis(3 cases of ipsilateral lung metastasis,1 case of bilateral int rapulmonary metastasis),4 cases of bone metastasis(3cases of osteolytic metastasis,1 case of osteogenic metastasis),and 1 case of liver metastasis.All 11cases of immunohistochemical NUT were positive.5 patients died,of which 3 were untreated and died of multiple organ failure 2 months after onset,1 patient died 2 months after chemotherapy and lobectomy,and 1 patient died 2 months after lobectomy.Six surviving patients were followed up for1-33 months after treatment.Conclusion NUT cancer is a rare gene related malignant solid tumor in the lungs,which can occur in both lungs.It is characterized by lobulated masses with large volume,uniform or uneven density,mild enhancement on enhanced sca ns,and often accompanied by multiple lymph node metastases in the hilar and mediastinum,making it more prone to distant metastasis.After receiving early treatment,su rvival time can be extended.