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中华肺部疾病杂志(电子版) ›› 2019, Vol. 12 ›› Issue (02) : 166 -170. doi: 10.3877/cma.j.issn.1674-6902.2019.02.007

所属专题: 经典病例 文献

论著

12例支气管腺样囊性癌临床特征及治疗预后分析
房延凤1, 李王平1, 金发光1, 李傲1, 鲁曦1, 张红军1, 南岩东1,()   
  1. 1. 710038 西安,空军军医大学(第四军医大学)唐都医院呼吸与危重症医学科
  • 收稿日期:2018-12-10 出版日期:2019-04-20
  • 通信作者: 南岩东
  • 基金资助:
    国家卫生公益行业专项(201402024); 唐都医院科技创新发展基金(2017LCYJ016); 唐都医院骨干人才基金(2016-01)

Clinical features, treatment, and prognosis of twelve cases of bronchial adenoid cystic carcinoma

Yanfeng Fang1, Wangping Li1, Faguang Jin1, Ao Li1, Xi Lu1, Hongjun Zhang1, Yandong Nan1,()   

  1. 1. Department of Respiratory and Critical Care Medicine, Tangdu Hospital, Air Force Medical University, Xi′an 710038, China
  • Received:2018-12-10 Published:2019-04-20
  • Corresponding author: Yandong Nan
  • About author:
    Corresponding author: Nan Yandong, Email:
引用本文:

房延凤, 李王平, 金发光, 李傲, 鲁曦, 张红军, 南岩东. 12例支气管腺样囊性癌临床特征及治疗预后分析[J]. 中华肺部疾病杂志(电子版), 2019, 12(02): 166-170.

Yanfeng Fang, Wangping Li, Faguang Jin, Ao Li, Xi Lu, Hongjun Zhang, Yandong Nan. Clinical features, treatment, and prognosis of twelve cases of bronchial adenoid cystic carcinoma[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2019, 12(02): 166-170.

目的

分析12例支气管腺样囊性癌患者的临床特征、治疗方式及预后情况以提高临床诊治水平。

方法

选择2012年2月至2018年2月唐都医院呼吸科确诊并治疗随访的12例支气管腺样囊性癌患者,收集分析其临床特征及治疗方法,随访生存信息情况。

结果

12例患者中位年龄53.5岁,女11例,男1例;均无吸烟史,6例既往无任何疾病史;主要症状咳嗽、咳痰、气短,部分有咯血、胸痛;8例发病于主气管中下段,主气管上段2例,右中间段支气管1例,左主支气管1例;胸部CT以结节、占位为主,部分见钙化、肉芽;支气管镜下表现为菜花样、结节样、肉芽样及球形新生物;气促指数2级5例,3级3例,4级4例;1例右肺全切,11例行2种以上的支气管镜下介入治疗,Ⅰ级缓解率、临床有效率、临床受益率均100%;3例无基线及复发转移,余9例以肺、骨转移多见;生存期均大于5个月。

结论

气管腺样囊性癌是一种低度恶性、好发于气管中下段、临床易出现气短症状的肿瘤,以肺、骨转移多见,支气管镜可明确病变范围及气道阻塞程度,支气管镜下介入治疗是非手术患者的一种有效选择,生存时间长。

Objective

To analyze the clinical features, treatment, and prognosis of 12 cases of bronchial adenoid cystic carcinoma.

Methods

We collected the clinical features and therapeutic regimens of 12 patients (11 females and 1 male, with the median age of 53.5 years), who were definitely diagnosed as bronchial adenoid cystic carcinoma and treated in the Respiratory Department in our hospital and carefully followed for their survival information from February 2012 to February 2018. A retrospective analysis was then performed with the clinical features, treatment, and prognosis information.

Results

All the 12 cases had no history of smoking, and 6 of them had no history of any illness. The main symptoms of all the 12 cases were cough, expectoration, and shortness of breath, and some of them had hemoptysis, chest pain or some other symptoms of respiratory system. In 8 cases, cancer arose from the middle-to-lower bronchial segments and in 2 cases, cancer arose from the upper segment of the main trachea (one from the right middle segment of the bronchus and the other one from the left main bronchus). Chest computed tomography (CT) was performed as a reference for primary diagnosis. In the 12 cases, nodules or masses were mainly shown on CT images, and calcification or granulation could also be observed in the tomography images of some cases. Under a bronchoscope, the tumor tissues were manifested as cauliflower-like, nodule-like, granulation-like, globe-like or other-shaped neoplasms. Borg index reached GradeⅡ in 5 cases, Grade Ⅲ in 3 cases, and Grade Ⅳ in 4 cases. Pneumonectomy was performed in the right lungs in one case and the other 11 cases accepted more than two kinds of bronchoscopic interventional therapies. The remission rate at level 1, clinical efficacy, and clinical benefit rate were all calculated as 100%. No baseline or recurrent metastasis was found in 3 cases, and in the other 9 cases, the carcinomas mainly metastasized to the lungs and bones. The survival time of 12 cases was all longer than 5 months.

Conclusion

Bronchial adenoid cystic carcinoma is a kind of low-grade malignant tumor, which mainly arises from the middle-to-lower bronchial segments. And the bronchial adenoid cystic carcinoma commonly metastasizes to the lungs and bones. The patients with bronchial adenoid cystic carcinoma are most likely to manifest as shortness of breath. Bronchoscopy can be used to define the extent of disease and obstructive degrees. Interventional therapy under a bronchoscope is an effective option, which can prognose a longer lifetime for nonoperative patients.

表1 12例患者基本情况及临床特征
表2 12例患者检查治疗方式及效果
表3 12例患者基线复发转移情况及随访
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