肺多形性癌23例临床及病理分析  

Pleomorphic carcinoma of the lung:a clinicopathological study of 23 cases

作　　者：段楚骁[1] 付圣灵[1] 付向宁[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院胸外科

出　　处：《临床外科杂志》2015年第6期451-453,共3页Journal of Clinical Surgery

摘　　要：目的：探讨肺多形性癌（pleomorphic carcinoma，PC）的临床表现、手术方式、病理特点及预后。方法回顾性分析我院胸外科2010年1月～2014年3月收治的23例肺多形性癌患者的临床及病理资料。结果23例患者发病年龄为35～75岁，平均年龄（54±11）岁，其中男16例，女7例，男女比为2．3∶1。17例患者有既往大量吸烟史，吸烟指数为400～1200，平均（688±225）。患者常见首发症状为咳嗽、痰中带血或咯血。术前纤维支气管镜检查难以确诊。23例患者中行肺癌根治术22例，行肿块活检术1例。23例患者中含有恶性上皮成分和多形性成分19例，4例仅含多形性成分，多形性成分中可见 CK 阳性表达。23例患者均获得随访，最长生存时间为18个月，仍存活，中位生存期12个月。结论肺多形性癌好发于中老年男性吸烟患者，免疫组织化学检查有助于明确诊断，外科手术为主要治疗方法。肺多形性癌预后差。Objective To investigate the clinical characteristics,surgical strategy,pathological features and prognosis of pulmonary pleomorphic carcinoma.Methods The clinicopathological data of 23 patients with pulmonary pleomorphic carcinoma who underwent surgical resection from January 201 0 to March 201 4 in Tongji Hospital were collected.Results There were 1 6 male patients and 7 female pa-tients,with the male /female ratio of 2.3∶1 .The mean age of was 54（35 ~75）years old.A total of 1 7 pa-tients were heavy smokers and the mean smoking index was 688（400 -1 200）.The initial main symptoms were cough,blood in phlegm and hemoptysis.It was difficult for fiberoptic bronchoscopy to confirm the di-agnosis.All patients underwent surgical resection,including 22 cases of radical resection and one case of biopsy.Microscopically,neoplastic epithelial cells and pleomorphic components were found in pulmonary pleomorphic carcinoma in 1 9 cases,and pleomorphic components only in the other 4 cases.Positive CK ex-pression in pleomorphic components was observed.The longest survival time was 1 8 months and the pa-tient was still alive.The median survival time was 1 2 months.Conclusion Pulmonary pleomorphic carci-noma usually occurs in middle-aged and elderly male smokers.Immunohistochemistry staining contribute to the diagnosis.The main treatment is surgery and the prognosis is poor.

关 键 词：肺肿瘤 多形性癌 病理 预后 

分 类 号：R734.2[医药卫生—肿瘤]