中国呼吸与危重监护杂志

中国呼吸与危重监护杂志

肺黏液表皮样癌一例并文献复习

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目的总结肺黏液表皮样癌(PMEC)的临床特征,以提高对该病的诊治水平。方法对 1 例 PMEC 患者的发病过程、临床表现、胸部影像学特点、病理特征及诊治经过进行回顾性分析。以“pulmonary”或“lung”和“mucoepidermoid carcinoma”为检索词在 PubMed 数据库进行检索,以“肺黏液表皮样癌”为检索词在中国知网数据库和万方数据库中进行检索,检索时间为 2013~2018 年,复习相关文献。结果患者女性,21 岁,因咳嗽、咳痰 5 个月余,咯血 3 个月余,发热 4 d 于 2017 年 3 月就诊。诊断为 PMEC(低级别)。入院后接受抗感染、纤维支气管镜吸痰、肺泡灌洗等治疗。住院期间患者抗感染效果欠佳,胸部 CT 检查提示右肺中叶占位性病变,经手术切除右全肺后逐渐好转。检索文献报道 13 例,患者无明显性别差异,中位年龄 40 岁(绝大多数小于 50 岁);临床表现多为咳嗽、发热、咯血,常伴有肺不张。大部分患者经手术切除后可好转,少数需接受包括放疗、化疗、靶向治疗等在内的综合治疗。结论PMEC 临床少见,目前病因尚未明确,病理以低级别为主,大部分患者经手术切除后可治愈。

ObjectiveTo summarize the clinical features of pulmonary mucoepidermoid carcinoma (PMEC) and improve the level of the diagnosis and therapy.MethodsA case of PMEC was reported and related literatures were reviewed in PubMed, WanFang data and China National Knowledge Infrastructure.ResultsA 21-year-old female patient, complaining of cough and expectoration for 5 months, intermittent hemoptysis for 3 months and repeated fever more than 4 days, was hospitalized in March 2017. After admission, the patient was diagnosed as low-grade PMEC and received anti-infection, fibrobronchoscope sputum aspiration and alveolar lavage therapy. During the hospitalization, the anti-infection of the patients was not much effective, and the chest CT examination suggested space-occupying lesions in the middle lobe of the right lung. After the surgical removal of the right lung, the syndrome of the patient was improved. A total of 13 patients were reviewed, there was no obvious gender difference, and the median age was about 40 years old (most frequently occurred in younger adults with an average age less than 50 years). Frequent clinical manifestations were cough, fever and hemoptysis, which were often accompanied with atelectasis. Most of the patients could be improved after surgical resection, and a few need comprehensive treatment including radiotherapy, chemotherapy and targeted treatment, etc.ConclusionsPMEC is rare and the etiology is still unclear. The pathology is mainly low-grade. Majority of patients with PMEC could be cured after surgical resection.

关键词: 肺肿瘤; 黏液表皮样癌; 临床特征; 治疗; 预后

Key words: Lung neoplasms; Mucoepidermoid carcinoma; Clinical features; Treatment; Prognosis

引用本文: 孙玲, 叶雨超, 杨华, 周亮, 黄波. 肺黏液表皮样癌一例并文献复习. 中国呼吸与危重监护杂志, 2018, 17(6): 599-603. doi: 10.7507/1671-6205.201805043 复制

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