肺肉瘤样癌8例临床病理特征并文献复习  

Clinicopathologic features of 8 patients with pulmonary sarcomatoid carcinoma and literature review

作　　者：冯文华[1] 张冠军[2] 高宇明[1] 蔡凤梅[3] 

机构地区：[1]西安航天总医院病理科,陕西西安710100 [2]西安交通大学医学院第一附属医院病理科 [3]西安市第四医院病理科

出　　处：《中国现代医药杂志》2016年第1期28-32,共5页Modern Medicine Journal of China

摘　　要：目的分析肺肉瘤样癌的临床病理特征,提高对其的认识。方法回顾性分析8例肺肉瘤样癌患者的临床病理资料与免疫组织化学特征,并复习相关文献。结果 8例患者中,男5例,女3例,年龄48～62岁,平均58岁,临床主要表现为咳嗽、咳痰、痰中带血、胸痛。组织学类型为多形性癌,梭形细胞癌,诊断时病理分期多为Ⅱ～Ⅲ期,免疫组织化学检查可见vimentin和上皮性标记物（CKpan,CK7,EMA等）共表达。8例均行根治性切除术,术后规范化疗5例,中位生存期为12个月。结论肺肉瘤样癌是肺少见的恶性肿瘤,临床表现无特异性,诊断依赖术后大标本病理组织学检查及免疫组织化学检查辅助,并需与多种疾病鉴别。治疗多采用手术为主的综合性治疗,但化疗的益处及预后因子尚有争议,有待进一步研究。Objective To improve the cognition of pulmonary sarcomatoid carcinoma （PSC） by analyzing the clinico-pathologic features of PSC. Methods Retrospectively analyzed the clinicopathologic data and immunohistochemical feature of 8 patients with PSC and reviewed related literatures. Results 8 patients included 5 males and 3 females. The mean age of the patients was 58 years（ranged from 48 to 62 years）. The main clinical symptoms was cough, sputum, bloody sputum,chest pain. The histological type was classified as pleomorphic carcinoma（PC）,spindle cell carcinoma（SCC）, the pathological stage was al-most II~Ⅲ stage. In these tumors,the expression of vimentin and epithelial markers （CKpan,CK7,EMA etc.） can be detected by immunohistochemical staining. 8 patients achieved a radical resection. Among these patients ,5 patients received adjuvant chemotherapy regularly,and their median survival time was 12 months. Conclusion PSC is a rarely histologic subtype of non-small cell lung cancer（NSCLC）. Compared with other NSCLC,there is no special clinical manifestation of PSC. Its definite diagnosis relies on postoperative pathological analysis and immunohistochemical staining ,and PSC needs to be distinguished from a variety of diseases. The treatment for PSC mainly depends on surgery in combination with chemotherapy ,radiotherapy and so on. However,whether the patients can benefit from chemotherapy and prognostic factors of PSC needs further research.

关 键 词：肺肉瘤样癌 病理特征 临床特征 

分 类 号：R734.2[医药卫生—肿瘤]