【摘要】 目的　探讨局限型细支气管肺泡癌的发病、诊断、治疗及预后。方法　收集我院胸外科自 1990年 4月至2 0 0 0年 4月手术治疗并经病理证实的局限型细支气管肺泡癌 42例进行回顾性分析。结果　本组病例占同期肺部肿瘤的 2 % ,临床症状、影像学征象与其它类型肺癌相似。本组行根治性切除 3 8例 (其中单肺叶切除 2 8例 ,双肺叶切除 5例 ,全肺切除 5例 ) ,姑息性切除 2例 ,剖胸探查 2例 (仅取活检 ) ,非根治切除的 4例术后加放疗和 (或 )化疗。现已死亡 2 0例 ,其中死于复发 12例 ,转移 8例。应用SPSS统计软件包进行有关分析 ,发现局限型BAC根治术后的 1、3、5年累计生存率分别为 77.3 %、5 2 .8%、2 9.6% ,与非细支气管肺泡癌腺癌组以及鳞癌组根治术后在总体生存率上无显著性差异 ,但在第 5年的时点上 ,细支气管肺泡癌的累计生存率为 2 9.6% ,非细支气管肺泡癌为 40 .3 % ,存在一定差异。Ⅱ期局限型细支气管肺泡癌组患者的中位生存时间为 2 6.8个月 ,非细支气管肺泡癌腺癌组为 42 .5个月 ,差异有统计学意义。结论　细支气管肺泡癌的生物学特性可能更具恶性倾向 ,治疗上与Non BAC腺癌可有所不同 ,术后辅助治疗可较腺癌更为积极 ,对Ⅱ期的局限型BAC可考虑辅以术后全身化疗或放疗 ,今后需作更深入的前瞻性研究加?更多还原

【Abstract】 Objective To investigate the clinical treatment and prognosis of localized bronchioloalveolar carcinoma(BAC).Methods Retrospective study was conducted in a total of 42 cases of localized bronchioloalveolar carcinoma hospitalized in our department from April 1990 to April 2000. Results 42 cases were occupied 2% of the lung tumor treated in the same period. Clinical symptoms and radiographic appearances of BAC were similar to other pathological types of lung cancer. 38 cases underwent radical operation, 2 cases underwent palliative operation and 2 cases received thoracotomy exploration biopsy, uncurative four cases received chemotherapy or radiotherapy after operation,and 20 cases died (12 cases died of recurrence and 8 case died of metastasis). The 1-、3-、5-year cumulative survival rate of localized BAC was 77.3%、52.8%、29.6%, respectively. The overall survival rate had no significant difference between BAC and Non-BAC or squamous group, but as for the point of 5 year, the cumulative survival rate of BAC was 29.6% and 40.3% of Non-BAC presenting some degree of difference. The median survival time of stageⅡ BAC was 26.8 months and 42.5 months of Non-BAC, showing significant differences. Conclusions Biological characteristics of BAC may be different from the Non-BAC and may be more malignant than Non-BAC, postoperative treatment would be more actively to BAC compared with adenocarcinoma. Postoperative chemotherapy or radiotherapy are recommended in stageⅡ BAC, further prospective research work should be done to verify.更多还原