肺外肿瘤与合并孤立性肺结节发生率关系初探

The relations of solitary pulmonary nodules with extra-pulmonary neoplasms: a preliminary investigation

目的探讨肺外肿瘤性质与其所合并的孤立性肺结节发生率及年龄间的相关关系。方法复习200例肺外肿瘤合并孤立性肺结节患者的临床与影像资料;并将肺结节的组织学特征与肺外肿瘤及患者年龄相对照。结果头颈部癌等肺外肿瘤患者合并的孤立性肺结节中,原发性肺癌/肺转移癌发生率之比均高:对于头颈部癌患者为34:4;对于膀胱癌等患者为36:11;涎腺癌等肺外肿瘤患者合并的孤立性肺结节中,原发性肺癌/肺转移癌发生率之比相若,为17:22;黑色素瘤、肉瘤或睾丸癌的患者合并的孤立性肺结节中,原发性肺癌/肺转移癌发生率之比倒置,为11:32。41例患者为良性结节。良性病变、肺癌与转移癌患者之间在年龄分布上相当重叠。结论较之肺转移癌及良性病变,原发性肺癌更与肺外肿瘤的组织学特征相关;患者年龄与所合并的孤立性肺结节性质间无明确特定关系。

Objective A study of the correlation of a solitary lung nodule and primary extra-pulmonary neoplasms and the patients' age. Methods The imagimg findings and the clinical data were studied in 200 cases of extra-pulmonary malignant neoplasm with solitary lung nodule. The histological nature of the nodule were correlated with those of the extrapulmonary neoplasms and with patients' age. Results In patients with carcinomas of the head, neck or urinary cyst, the solitary lung nodules were more likely to be a primary pulmonary carcinoma than a metastatic nodule(the ratio: 34:4 for patients with head and neck cancers; 36:11 for patients with carcinoma arising in urinary cyst). Conversely,in patients with melanoma, sarcoma or carcinoma of testis,were more likely to have a solitary metastatic nodule than a primary pulmonary carcinoma (ratio: 11:32). Patients with carcinomas of the salivary glands, had fairly even odds (ratio, 17:22). And there were 41 patients with a benign pulmonary nodule. There was a substantial overlap in age distribution among the patients with benign disease, lung cancer, and pulmonary metastasis. Conclusion The likelihood of a primary lung cancer versus a metastasis depends on the histological nature of the extra-pulmonary neoplasm, while there is no statistical connection between the nature of the solitary lung nodule and the patient's age.