肺良性转移性平滑肌瘤的临床特点及其预后相关因素  

Clinical characteristics and prognostic factors of pulmonary benign metastasizing leiomyoma

作　　者：杜倩娥 唐文军 林海锋 DU Qian’e;TANG Wenjun;LIN Haifeng(Department of Medical Oncology,Second Affiliated Hospital of Hainan Medical College,Haikou 570100,China)

机构地区：[1]海南医学院第二附属医院肿瘤内科,海口570100

出　　处：《临床与病理杂志》2022年第7期1536-1542,共7页Journal of Clinical and Pathological Research

基　　金：海南省自然科学基金青年基金(819QN362);海南省卫计委科研项目(19A200114)。

摘　　要：目的:探讨肺良性转移性平滑肌瘤(pulmonary benign metastasizing leiomyoma,PBML)的临床特点及其预后相关因素。方法:检索并收集1957年1月至2020年12月PubMed、中国知网及万方数据库中PBML案例报道的相关临床资料,结合海南医学院第二附属医院收治的1例PBML患者的诊治过程,通过χ^(2)检验及Fisher精确检验分析其危险因素及预后。结果:共检索到151例PBML患者,均为女性,年龄(46.10±7.05)岁,其中147例既往患有子宫肌瘤,大部分为胸部CT体检发现双肺多发结节,病理HE染色示梭形肿瘤细胞,免疫组织化学示ER(+)、PR(+)、Ki-67(−)或低表达。相关分析显示:患病年龄、发病间隔时间、结节大小、ER和PR表达、治疗方案与预后无明显相关(均P>0.05)。结论:PBML极为罕见,多见于有子宫肌瘤病史的育龄期女性,该病预后好,生存期长,其预后与发生肺转移时间、起病年龄、结节大小、ER和PR表达及治疗方案选择无关,有关预后的相关因素仍需进一步探究。Objective:To investigate the clinical features and prognostic factors of pulmonary metastatic leiomyoma(PBML).Methods:The clinical data of PBML cases reported in PubMed,CNKI and Wanfang database from January 1957 to December 2020 were retrieved and collected.Combined with the diagnosis and treatment process of 1 PBML patient admitted to the Second Affiliated Hospital of Hainan Medical College,the risk factors and prognosis were analyzed byχ^(2)test and Fisher’s accurate test.Results:A total of 151 PBML patients,all female,aged 46.10±7.05 years,including 147 patients with previous uterine fibroids,often due to chest CT physical examination found multiple nodules in both lungs,pathological HE staining showed spindle tumor cells,immunohistochemistry showed positive expression of ER and PR,negative or low expression of Ki-67.Correlation analysis showed that there were no significant differences in age,time between onset,nodule size,expressions of ER and PR,treatment plan and prognosis(all P<0.05).Conclusion:PBML is extremely rare,it is more common in women of reproductive age with a history of uterine fibroids,it does not show specific clinical symptoms,the disease has a better prognosis and a long survival period.However,the time of lung metastasis,age,nodule size,immunological expression and treatment options did not show a significant impact on the prognosis,the related factors of the prognosis still need to be further explored.

关 键 词：良性转移性平滑肌瘤 肺转移 子宫平滑肌瘤 危险因素 预后 

分 类 号：R734.2[医药卫生—肿瘤]