| 摘要: |
| 目的了解≤1.0cm原发性周围型微小肺癌的临床特征及其预后情况。方法采用回顾性研究方法对≤1.0cm微小肺癌的临床特征、CT征象及其预后情况进行分析。结果193例微小肺癌中190例（98.5%）为肺腺癌，微小肺腺癌以女性、≤60岁患者为主，术前外周血清癌胚抗原（CEA）水平多在正常范围内，病理学类型多表现为原位腺癌或微浸润腺癌，CT征象多表现为纯磨玻璃结节或混合磨玻璃结节，均无淋巴结转移且临床分期为0期或Ⅰ期。不同大小0.5~0.7（0.6±0.07）cm和＞0.7~1.0（0.9±0.09）cm的微小肺腺癌患者在性别、年龄、吸烟状态、术前血清CEA水平、肿瘤是否侵犯肺膜、有无淋巴结转移、临床分期、手术方式、病理类型和CT征象等方面比较，差异均无统计学意义（均P＞0.05）。不同病理学类型的微小肺腺癌患者在性别、吸烟状态、CEA水平、临床病理分期、CT征象方面比较，差异均有统计学意义（均P＜0.05）。对微小肺癌患者随访14~96个月后，所有患者手术后预后均较好，无死亡病例，总生存率为100.0%。结论微小肺癌以腺癌为主，均无淋巴结转移发生，预后较好。对于CT征象表现为纯磨玻璃结节，术前外周血清CEA正常的微小肺癌患者可采取楔形切除或肺段切除的手术方式。 |
| 关键词: 微小肺癌 腺癌 肿瘤大小 病理学类型 预后 |
| DOI：10.12056/j.issn.1006-2785.2017.39.05.2016-1363 |
| 分类号: |
| 基金项目:国家卫生计生委科学研究基金（WKJ2014-2-021）；浙江省科技计划项目（2015C33254） |
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| Clinical features and prognosis of primary peripheral lung carcinoma with micro-size |
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CHAI Zhenda, CHEN Zhijun, ZHU Wangyu, WANG Shanjun, WANG Zhaoyu, ZHANG Yongkui
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Affiliated Zhoushan Hospital of Wenzhou Medical University
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| Abstract: |
| Objective To investigate the clinical characteristics and prognosis of patients with peripheral micro-size lung carcinoma. Methods The clinical features, imaging findings and prognosis of 193 patients with primary peripheral lung carcinoma, whose cancer size was ≤1cm in diameter, were retrospectively analyzed. Results Among 193 patients there were
139 females and 54 males with a mean age of 53.5±10.3 years (22-79). Most of patients had low preoperative peripheral CEA
levels (＜5.0IU/ml). Adenocarcinoma was the dominant pathological type (190/193, 98.5% ), and the main subtypes were adenocarcinoma in situ (AIS) and micro-infiltrating adenocarcinoma (MIA). The CT findings were pure ground glass opacity (pGGO) and mixed ground glass opacity(mGGO). All patients had no lymph node metastasis with a pathological stage 0 or stage
Ⅰ. There were significant differences in gender, smoking status, CEA levels, pathological stages and CT findings among different
types of micro-sized lung adenocarcinoma(AIS, MIA, IAC) (all P＜0.05), whereas no significant difference between patients with tumor size 0.5-0.7cm and those 0.7-1.0cm (all P ＞0.05). After 14-96 months follow-up, all patients were alive after surgery. Conclusion The main subtype of micro-sized lung cancer was adenocarcinoma, with no lymph node metastasis and favorable prognosis. Wedge resection and segmentectomy are recommended for those patients with pGGO and normal preoperative CEA level. |
| Key words: Micro-sized lung cancer Adenocarcinoma Tumor size Histology Prognosis |
