手术切除7例临床诊断为乳腺癌肺寡转移灶的病理结果及其临床意义  

Pathological findings and clinical significance of surgical resection of 7 cases of clinically diagnosed lung oligometastasis of breast cancer

作　　者：周雅卿 王淑慧 赵永林 赵阳[1] 贾丽君[1] 姜建涛[2] 张晋[2] 管海涛[1] ZHOU Yaqing;WANG Shuhui;ZHAO Yonglin;ZHAO Yang;JIA Lijun;JIANG Jiantao;ZHANG Jin;GUAN Haitao(Oncology Department,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,Chin;Thoracic Surgery Department,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西安交通大学第二附属医院肿瘤病院,陕西西安710004 [2]西安交通大学第二附属医院胸外科,陕西西安710004

出　　处：《临床医学研究与实践》2022年第12期5-9,共5页Clinical Research and Practice

摘　　要：目的探讨手术切除临床诊断的乳腺癌肺寡转移灶的临床价值。方法回顾性分析7例临床诊断为乳腺癌肺寡转移患者肺部病灶手术切除的病理结果、后续治疗及随访结果。结果7例患者中,1例初诊乳腺癌患者同时诊断肺寡转移,在乳腺癌术后0.6个月接受了肺转移灶切除术,术后病理示肺腺癌,后续给予6个周期的TP化疗;其余6例患者均在术后随访过程中发现肺寡转移灶。其中1例患者中发现了双肺共有三个结节,经过5年随访后确定为乳腺癌肺转移可能,随后接受手术治疗,术后病理示其中两个病灶为乳腺癌肺转移,一个病灶为肺腺癌,术后给予依西美坦治疗。1例患者为乳腺癌肺转移并纵膈淋巴结转移,术后给予长春瑞滨联合顺铂化疗6个周期,然后给予氟维司群内分泌治疗,随访36个月后发现肝转移,加用哌柏西利治疗至今。此外,1例患者为原发性肺癌;1例患者为结核感染;2例患者为隐球菌感染(其中1例同时为宫颈癌、乳腺癌术后患者)。原发性肺癌患者手术切除后均未给予辅助治疗;结核、隐球菌感染患者病灶切除后亦未给予后续治疗;6例患者随访至今,均未见肿瘤复发、转移。结论手术切除乳腺癌(术后或初诊时)临床诊断的肺寡转移灶进行病理检查对于明确诊断并指导治疗具有重要的价值,且对改善乳腺癌的预后可能具有一定的价值。对手术切除乳腺癌(术后或初诊时)临床诊断的肺寡转移病灶应持积极态度,但其改善预后的临床价值仍需要前瞻性的临床研究予以证实。Objective To investigate the clinical value of surgical resection of clinically diagnosed lung oligometastasis of breast cancer.Methods The pathological results of pulmonary lesion resection,subsequent treatment and follow-up results of 7 patients of clinically diagnosed lung oligometastasis of breast cancer were retrospectively analyzed.Results Among the 7 patients,1 case was newly diagnosed breast cancer with lung oligometastasis,and the patient underwent pulmonary lesion metastasectomy at 0.6 months later after the breast surgery,the postoperative pathology showed lung adenocarcinoma,and the patient subsequently received 6 cycle of TP chemotherapy;the lung oligometastasis were found in the other 6 cases during postoperative follow-up.Of a patients,three nodules were found in bilateral lungs,the patient was confirmed as possible pulmonary metastases of breast cancer after 5-year follow-up,then was give surgery,and the postoperative pathology showed that two lesions were lung metastases of breast cancer,one lesion was lung adenocarcinoma,and exemestane treatment was given after operation.One case was lung metastasis of breast cancer with mediastinal lymph nodes metastases,and received endocrine therapy of fluvestone after 6 cycles of chemotherapy with vinorelbine combined with cisplatin;after 30 months of follow-up,liver metastases was found,then palbociclib was added to the treatment until now.In addition,one case was primary lung cancer,1 case was tuberculosis,and 2 cases were cryptococcus infection(1 case of them was after cervical cancer and breast cancer surgeries).No adjuvant therapy was given to patients with primary lung cancer after surgical resection.The patients with tuberculosis and cryptococcus infections did not receive subsequent treatment after lung lesions resection.No tumor recurrence or metastasis were observed in the other 6 patients up to now.Conclusion The pathological examination of clinically diagnosed lung oligometastasis of breast cancer(postoperative or newly diagnosed patient)by surgi

关 键 词：乳腺癌 肺 寡转移 

分 类 号：R737.9[医药卫生—肿瘤]