[Experience and Progress Processing Policy of Simultaneous Multiple Primary Lung Cancer]

Zhongguo Fei Ai Za Zhi. 2018 Mar 20;21(3):180-184. doi: 10.3779/j.issn.1009-3419.2018.03.11.
[Article in Chinese]

Abstract

Background: Simultaneity multiple primary lung cancer always is a rare disease, but in recent years due to the progress of the diagnosis and treatment means detection rate increased. This study summarized the clinical data of 31 cases of synchronous multiple primary lung cancer (sMPLC) analysis, further to explore the diagnosis, treatment and prognosis of MPLC.

Methods: Sum up the clinical data of 31 cases of simultaneous multiple primary lung cancer, the diagnostic method, surgical methods, pathology, were retrospectively analyzed.

Results: All the patients are thoracoscope surgery, no deaths. Thin high resolution computed tomography (CT) in preoperative found multiple lung nodules. Lesions located in the same side of the same period surgical treatment, the operation method is given priority to with under the thoracoscope lung + the lobectomy; Lesions located in bilateral, all staged operation, the time interval for 3 months-4 months.

Conclusions: Thin layer distinguish CT preoperative diagnosis is the best way to simultaneous multiple primary lung cancer. Multiple primary lung cancer incidence of ipsilateral lung at the same time higher than that of bilateral lung (23:8), type, around 94%, the most common histology to adenocarcinoma, 80.6% (25/31). Primary lesions under thoracoscope lobectomy plus the lobectomy of secondary lesions is the most commonly used.

背景与目的 同时性多原发肺癌(synchronous multiple primary lung cancer, sMPLC),既往属少见疾病,但近年来由于诊疗手段的进步检出率逐渐升高。但关于MPLC的发病机制、诊断、鉴别诊断和临床处理策略仍存在诸多争议。本研究对31例sMPLC的临床资料进行总结分析,进一步探讨sMPLC的诊断、治疗和预后。方法 归纳总结31例sMPLC的临床资料,回顾性分析其诊断方法、手术方式、病理资料。结果 所有患者均行胸腔镜手术,无死亡病例。术前均行薄层高分辨计算机断层扫描(computed tomography, CT)发现肺部多发结节。病灶位于同侧者均同期行手术治疗,手术方式以胸腔镜下肺叶+亚肺叶切除为主;病灶位于双侧者,均分期手术,时间间隔为3个月-4个月。结论 薄层高分辨CT是术前诊断sMPLC的最佳方法。sMPLC同侧肺发病率高于双侧肺(23:8),周围型多见,占94%,组织学类型以腺癌最多见,占80.6%(25/31)。胸腔镜下主病灶的肺叶切除+次要病灶的亚肺叶切除是最常用的术式。.

Keywords: Multiple primary lung cancer; Surgery; Thin layer distinguish CT; Thoracoscope.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Neoplasms, Multiple Primary / diagnosis
  • Neoplasms, Multiple Primary / diagnostic imaging
  • Neoplasms, Multiple Primary / surgery*
  • Retrospective Studies
  • Tomography, X-Ray Computed