摘要
目的：肠型腺癌是非小细胞肺癌的一种少见病理类型，本文主要讨论肺肠型腺癌的临床和病理特征，诊断和治疗方法。方法：回顾性分析2013年至2016年5月间诊治的6例肺肠型腺癌患者的临床资料。结果：男2例，女4例，发病年龄25~78岁，以“咳嗽胸闷”起病4例，伴“颈部包块”4例，以“头晕恶心呕吐”起病1例；影像学主要表现为肺部、锁骨上及纵隔占位，病理形态及免疫组化均提示肿瘤来自于结直肠癌，但胃肠镜均未见异常占位；根治性和姑息性手术各1例，其中1例根治术后复发转移；1例行脑单发转移灶射波刀治疗后未再接受治疗，余5例患者均接受了全身化疗。截止随访结束，4例患者死亡，生存时间最短9个月，最长32个月。结论：肺肠型腺癌易与结直肠癌肺转移相混淆，确诊需要排除肠道病变，早期治疗以手术治疗为主，关于系统治疗方案有待临床进一步研究。
Objective： Primary lung enteric adenocarcinoma is a rare type of invasive lung carcinoma. This article mainly discusses the clinicopathological characteristics, diagnosis and treatment of primary lung enteric adenocarcinoma. Methods： Retrospectively analysed clinical records of 6 cases admitted in hospital from Feb 2013 to May 2016, and reviewed the literature of primary lung enteric adenocarcinoma.Results： Two patients were male and four patients were female with the age ranged from 25 to 78 years. hTeir symptoms consisted mainly of cough chest stuffy with 4 patients, neck mass with 1 case, dizziness nausea vomiting with 1 case; imagining scan showed mass of lung and or mediastinal, pathology form and the immunochemistry showed all positive for intestinal immune phenotypes and some positive for lung cancer immunophenotypic. But no tumor was found by gastrointestinal endoscopes; 1 case recurrence and metastasis after radical operation; 1 patient underdone palliative surgery, 1 patient with brain solitary metastasis onset received CyberKnife and without system treatment, and 5 patientsunderwent chemotherapy. At the end of follow-up, 4 patients died, over survival time as long as 32 months. Conclusion：The primary lung enteric adenocarcinoma was easily confused with pulmonary metastases from colorectal cancer, conifrmed diagnosis need to rule out intestinal lesion, the main early treatment is surgery, and systematic treatment programs need to be further studied.
出处
《临床与病理杂志》
2016年第8期1134-1139,共6页
Journal of Clinical and Pathological Research
关键词
肠型腺癌
结直肠癌
免疫组织化学
诊断
lung enteric adenocarcinoma
colorectal cancer
immunohistochemistry
diagnosis
