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本文作者报告日本国立癌中心外科手术切除的1,015例原发性肺癌中的22例多发性肺癌,并讨论了本病的临床特征、诊断、组织类型及其治疗和预后等。本组病例平均年龄61.7岁,男与女比例为20:2,男性显著高于女性。22例中21例为二重癌,1例为三重癌。非同时多发性肺癌2例,同时多发性肺癌20例,其中19例为单侧性,仅1例为双侧性。本组病例中的20例均有大量吸烟史。本病的诊断,大多采用 Warren 和 Gates 提出的标准。这对于不同组织类型的多发性肺癌的诊断没有困难,但对于同组织类型者按此标准常难以诊断。作者提出应用上述标准的基础上要重视以下病理组织学表现:鳞状上皮癌时,与原有支气管上皮的连续性、支气管上皮及血管有无浸润;腺癌时,支气管有无集束性变化、中心都癜痕形成及其分化度、细胞亚型等。
The authors report 22 cases of multiple lung cancer in 1,015 primary lung cancers that were surgically removed by the National Cancer Center of Japan. The clinical features, diagnosis, tissue types, treatment, and prognosis of the disease were discussed. The average age of the patients in this group was 61.7 years, with a male to female ratio of 20:2. Men were significantly higher than women. Of the 22 cases, 21 were double cancers and 1 was triple cancer. There were 2 non-simultaneous multiple lung cancers and 20 multiple lung cancers. Of these, 19 were unilateral and only 1 was bilateral. Of the 20 cases in this group, there were a lot of smoking history. The diagnosis of this disease is mostly based on the criteria proposed by Warren and Gates. This is not difficult for the diagnosis of multiple lung cancers of different tissue types, but it is often difficult for patients of the same tissue type to be diagnosed according to this standard. The authors put forward the following criteria to apply the following criteria to pay attention to the following histopathological manifestations: squamous cell carcinoma, with the continuity of the original bronchial epithelium, bronchial epithelial and vascular infiltration; adenocarcinoma, the presence of bundles of bronchial changes, In the center, scar formation and its degree of differentiation, cell subtypes, etc.