细支气管肺泡癌20例临床分析

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1、郑州大学硕士学位论文细支气管肺泡癌20例临床分析姓名：徐坤申请学位级别：硕士专业：外科学指导教师：杨鲲鹏201205AbstractClinicalanalysisof20patientswithbronchioloaIveoIarinomacarclnoabronCnl010aIVeolarPostgraduate：KunXuTutor：Prof．KunpengYangDepartmentofThoracicSurgeryTheSecondClinicalMedicalCollegeofZhengzhouUniversityZhengzhouHena

2、n450014ObjectiveBronchiolalveolarcarcinoma(BAC)whichhasuniqueepidemiology,pathology,radiologyandclinicalfeaturesisasubtypeoflungadenocarcinoma．ThisarticleaimstoexploretheclinicalcharacteristicsofBACandimprovethediagnosisandtreatment．MethodsWeretrospectivelyanalyzedtheclinicaldat

3、eof20BACpatientswhowereadmittedtoTheSecondAffiliatedHospitalofZhengzhouUniversityfromApril2007toApril2009．WecombinedwithpublishedliteraturetosummarizetheclinicalfeaturesofBAC，andmakeastatisticalanalysis．ResultsTheratioofmalestofemaleswas1：1．5in20BACpatients．Themedianagewas57year

4、s．Theproportionofneversmokerswas20％，allofwomenwereneversmokers．Firstsymptomswerecough，spitting，hemoptysis，chestpainanddyspnea·6patients(30％)hadahistoryofmisdiagnosisbeforeopermion，allofthemweremisdiagnosedaslunginfections．Therewerethreemajorradiographicpatterns：solitarypulmonary

5、nodule(n=l1)，localizedconsolidation(n58)，anddiffusedisease(n=1)．Only4patientsshowedpathologicstageI，TheotherstageswereII(7)，III(8)，andIV(1)．Lobectomieswasperformedin17patients，IIIAbstractpueumonectomiesin14，andexceptIexplorativethoracotomy，allofthemhadlymphnodedissections．Noperi

6、operativedeathoccurred．Follow．uptoMarch2012，theoverallfollow—upratewas90％．Therangeofsurvivaltimewasfrom9monthsto52months．Themediansurvivaltimewas29months，The1．，2．and3-yearsurvivalrateswere78．9％，57．9％，28．1％．，1■‘00nCJUtionThesurvivalratewassignificantlylowerthanthatreportedintheli

7、terature，itmaybeconnectedwithsmallsamplesize，datebiasandpathologicaldiagnosis．UnivariateanalysisrevealedthatN2grouplymphnodemetastasiswerestatisticallysignificantfactorsaffectingsurvival，whilegenderisnot．MostpatientsbeforeoperationCall’tobtaintheBACpathologicalevidence．Surgicalt

8、reatmentisthefirstchoiceofBACtherapy．KeywordsBr