气道分泌物淀粉酶显著增高的肺腺癌1例  

A case of lung adenocarcinoma with markedly elevated amylase in airway secretions

作　　者：于歆 苏杰[2] 王蓓[3] 王一民 Yu Xin;Su Jie;Wang Bei;Wang Yimin(National Center for Respiratory Medicine,State Key Laboratory of Respiratory Health and Multimorbidity,National Clinical Research Center for Respiratory Diseases,Institute of Respiratory Medicine,Chinese Academy of Medical Sciences,Center of Respiratory Medicine,Department of Pulmonary and Critical Care Medicine,China‑Japan Friendship Hospital,Beijing 100029,China;Department of Pulmonary and Critical Care Medicine,The second people′s Hospital of Foshan,Foshan 528000,China;Department of Pathology,China‑Japan Friendship Hospital,Beijing 100029,China;Clinical Center for Pulmonary Infections,Capital Medical University,Beijing 100029,China)

机构地区：[1]国家呼吸医学中心呼吸和共病全国重点实验室、国家呼吸疾病临床研究中心、中国医学科学院呼吸病学研究院、中日友好医院呼吸中心、中日友好医院呼吸与危重症医学科,北京100029 [2]佛山市第二人民医院呼吸与危重症医学科,佛山528000 [3]中日友好医院病理科,北京100029 [4]首都医科大学呼吸系感染临床诊疗与研究中心,北京100029

出　　处：《中华结核和呼吸杂志》2023年第11期1124-1126,共3页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：本文报道1例中年男性患者,因“间断咳嗽、咳痰1年余,加重伴呼吸困难2个月”入院,患者肺内病灶影像学表现具有多样性,但因咳嗽剧烈无法配合活检操作,临床以特殊性状痰液作为切入点,检测气道分泌物淀粉酶显著升高,并在试验性泵入醋酸奥曲肽改善咳嗽症状后完成病灶活检,最终确诊肺腺癌,同时发现肺腺癌分泌淀粉酶的特性。期待通过该例患者诊疗过程及文献资料,拓展临床诊断思路并了解肺腺癌少见临床特点。A 45‑year‑old male patient was admitted to the hospital because of intermittent cough and expectoration for more than 1 year,worsened by dyspnea for 2 months,and was finally diagnosed with lung adenocarcinoma.The CT scan of the chest revealed lesions of diversity with fibrosis,mass and effusion,but his severe cough limited biopsy of the lesions.The difficult process of diagnosis was aided by the further analysis of the sputum,which showed significantly elevated amylase without any evidence of pancreatic disease.The cough was relieved by intravenous pumping octreotide acetate,and both CT‑guided lung biopsy and transbronchial biopsy revealed the lung adenocarcinoma.The diagnostic process of this case provided a helpful diagnostic thinking and demonstrated the rare clinical features of lung adenocarcinoma.

关 键 词：醋酸奥曲肽 咳嗽症状 气道分泌物 肺内病灶 肺腺癌 中年男性 呼吸困难 咳痰 

分 类 号：R734.2[医药卫生—肿瘤]