论文部分内容阅读
目的探讨支气管黏液表皮样癌的临床病理特点、预后相关因素及Ki-67的表达。方法回顾性总结21例支气管黏液表皮样癌的临床病理特征及预后,并采用免疫组化SP法检测Ki-67。结果患者术前均行纤维支气管镜检查并发现病变,有16例经活检确诊为黏液表皮样癌。全组均接受手术治疗,肺叶切除13例,袖式肺叶切除3例,全肺切除4例,开胸探查1例。21例术后组织病理学检查中,17例为低度恶性,4例为高度恶性。术后平均随访68.3月,17例低度恶性(T1-3N0-1M0)均存活,其中生存时间﹥5年者8例,包括1例有淋巴结转移者;4例高度恶性(T2-3N0-2M0)最长生存时间仅13个月。Ki-67增殖指数在高、低恶性组间分别是(10.41±3.23)%和(5.18±2.41)%,差异显著(P<0.05)。结论低度恶性黏液表皮样癌经手术治疗可以治愈,但高度恶性者常易发生转移,预后较差。肿瘤分期、恶性程度、区域淋巴结转移情况与预后密切相关。Ki-67表达水平与其组织分化程度有关。
Objective To investigate the clinicopathological features, prognostic factors and expression of Ki-67 in bronchial mucoepidermoid carcinoma. Methods The clinical pathological features and prognosis of 21 cases of bronchial mucoepidermoid carcinoma were retrospectively reviewed. Ki-67 was detected by immunohistochemical SP method. Results All patients underwent fiberoptic bronchoscopy before the operation and found lesions. Sixteen cases were diagnosed as mucoepidermoid carcinoma by biopsy. All patients underwent surgical treatment with 13 cases of lobectomy, 3 cases of sleeve-type lobectomy, 4 cases of pneumonectomy, and 1 case of open chest exploration. In 21 cases of postoperative histopathological examination, 17 cases were low grade and 4 cases were highly malignant. After a mean follow-up of 68.3 months, 17 cases of low-grade (T1-3N0-1M0) all survived, including 8 cases with a survival time >5 years, including 1 case with lymph node metastasis; 4 cases with high-grade malignancy (T2-3N0-2M0). ) The maximum survival time is only 13 months. The Ki-67 proliferation index was (10.41±3.23)% and (5.18±2.41)% in the high and low malignant groups, respectively, with significant differences (P<0.05). Conclusion Low-grade malignant mucoepidermoid carcinoma can be cured by surgery, but high-grade malignancy is often easy to metastasize, and the prognosis is poor. The stage, degree of malignancy, regional lymph node metastasis and prognosis are closely related. The expression level of Ki-67 is related to its degree of tissue differentiation.