薄壁空洞性肺癌:24例病例分析及文献回顾  

Thin-walled Cystic Lung Cancer: An Analysis of 24 Cases and Review of Literatures

作　　者：郭俊唐[1] 梁朝阳[1] 初向阳[1] 周乃康[1] 孙玉鹗[1] 刘阳[1] 

机构地区：[1]解放军总医院胸外科,北京100853

出　　处：《中国肺癌杂志》2014年第7期553-556,共4页Chinese Journal of Lung Cancer

摘　　要：背景与目的英国学者Anderson和Pierce于1954年首先报道了表现为囊性病变的肺癌。作为少见的肺癌特殊表现类型,薄壁囊性肺癌在临床中经常被误诊。本研究旨在探讨薄壁空洞性肺癌的临床特点、影像学特点,诊断及治疗。方法自2007年3月-2013年12月,解放军总医院胸外科共收治4,897例原发性肺癌患者,其中24例影像学表现为薄壁空洞型肺癌。我们将影像学上表现为囊性且75%以上囊壁厚度小于4 mm的肺癌定义为薄壁空洞性肺癌。回顾性总结24例病例的临床资料、病理结果及随访情况。结果薄壁空洞型肺癌在我科同期接受手术的肺癌中比例为0.49%(24/4,897)。其中男性19例,女性5例,平均年龄56.5岁。14例无临床症状,于查体时发现。10例有呼吸道症状。24例患者中18例为腺癌(包括原位腺癌及微浸润腺癌),3例鳞癌,1例大细胞癌,1例小细胞癌,1例腺鳞癌。平均随访时间28个月,3例因肺癌死亡,其余21例未见复发。结论薄壁空洞型肺癌是肺癌少见的影像学表现类型,临床中应避免误诊。其具体形成机制并不明确,可能是肺癌形成的某一阶段。薄壁空洞型肺癌如能早期诊断,可获得较好预后。Background and objective Lung cancer presenting as cystic lesions was ifrst described by Anderson and Pierce in 1954. Lung cancer presenting as cysts is a rare entity in clinical practice. Differential diagnosis is diffcult in the benign-like cyst. hTis study investigated the clinical characteristics, diagnosis and treatment of lung cancer presenting as cysts. Methods We conducted a retrospective analysis of the clinical records of 24 patients who underwent surgery for a primary lung cancer presenting as cysts in our department between 2007 and 2013. We deifned a‘hTin-walled cyst’ as a cavitary lesion with a wall thickness of 4 mm or less along at least 75%of the circumference of the lesion. hTe whole group underwent post-operative follow-up. Results hTe incidence of cystic lung cancer was 0.49%（24/4,897） of surgical cases. hTe subjects’ age ranged from 19 to 77 yr with a median age of 56.5 yr. Ten cases presented with respiratory symptoms while 14 showed abnormal shadows on a chest CT without symptoms. Histological analysis showed that 18 cases were of adenocarcinoma, three of squamous cell carcinoma, one of small cell carcinoma, one of adenosquamous carcinoma and one of large cell carcinoma. hTree patients were dead, and the remaining 21 patients are alive and disease free at the end of follow-up. Conclusion Cystic lung cancer should be kept in mind during the differential diagnosis of focal benign cyst. Cystic lung cancer could achieve a good outcome if early diagnose can be obtained.

关 键 词：肺肿瘤 空洞 囊性病变 计算机断层扫描 

分 类 号：R734.2[医药卫生—肿瘤]