吉林大学学报(医学版) ›› 2022, Vol. 48 ›› Issue (4): 1040-1044.doi: 10.13481/j.1671-587X.20220426

• 临床医学 • 上一篇    

氩氦刀冷冻消融治疗肺黏液表皮样癌1例报告及文献复习

江洋1,彭昭文1,易舒婧1,尤海玲1,冯高飞1,刘传波2(),胡凯文2   

  1. 1.北京中医药大学深圳医院肿瘤科,广东 深圳 518000
    2.北京中医药大学东方医院肿瘤科,北京 100078
  • 收稿日期:2021-09-23 出版日期:2022-07-28 发布日期:2022-07-26
  • 通讯作者: 刘传波 E-mail:lcb4820@163.com
  • 作者简介:江 洋(1991-),男,辽宁省大连市人,住院医师,医学硕士,主要从事中西医结合治疗恶性肿瘤临床方面的研究。
  • 基金资助:
    科技部国家重点研发计划项目(2018YFC1705102);北京中医药大学深圳医院青年教师项目(2020-BUCMSZYNKY01)

Argon-helium knife cryoablation in treatment of pulmonary mucoepidermoid carcinoma: A case report and literature review

Yang JIANG1,Zhaowen PENG1,Shujing YI1,Hailing YOU1,Gaofei FENG1,Chuanbo LIU2(),Kaiwen HU2   

  1. 1.Department of Oncology,Shenzhen Hospital,Beijing University of Traditional Chinese Medicine,Shenzhen 518000,China
    2.Department of Oncology,Dongfang Hospital,Beijing University of Traditional Chinese Medicine,Beijing 100078,China
  • Received:2021-09-23 Online:2022-07-28 Published:2022-07-26
  • Contact: Chuanbo LIU E-mail:lcb4820@163.com

摘要: 目的

分析肺黏液表皮样癌患者的临床表现、影像学表现、病理学特征、治疗手段和预后,为该病的治疗和诊断提供依据。

方法

收集 1 例肺黏液表皮样癌患者的临床资料,并结合相关文献复习,探讨肺黏液表皮样癌的临床特点、诊断和治疗方法。

结果

患者,男性,59 岁,因“诊断肺癌1年余,乏力1周”入院。查体,双胸廓对称,双肺语音震颤无增强,双肺叩诊呈清音,听诊双肺呼吸音清,未闻及干湿啰音。根据既往史明确诊断为肺黏液表皮样癌。入院时胸部 CT 片提示右上肺纵隔旁见团块影,密度减低,CT值为29~43 Hu,胸膜边缘模糊,大小为68 mm×40 mm,增强后动脉期CT值为73 Hu,静脉期CT值为83 Hu。右肺门及纵隔可见淋巴结影。既往右肺肿物根治性切除术后,化疗后复发,且不能耐受继续化疗和靶向治疗,遂行CT引导下右肺肿物氩氦刀冷冻消融术,术后1个月复查胸部CT检查结果显示病灶明显缩小,密度减低,CT值为34 Hu,大小为23 mm×26 mm,增强后未见明显强化,右肺门及纵隔淋巴结较前缩小。

结论

肺黏液表皮样癌是一种特殊类型的肺癌,可无明显阳性体征,高级别肺黏液表皮样癌患者术后易复发,化疗效果差,缺乏疗效确切的靶向药物。氩氦刀冷冻治疗可局部消融病灶,延长患者生存期并提高生活质量。

关键词: 肺肿瘤, 肺黏液表皮样癌, 绿色治疗, 冷冻消融, 影像学

Abstract: Objective

To analyze the clinical manifestations, imaging and pathological features, treatment methods and prognosis of pulmonary mucoepidermoid carcinoma,and to provide the basis for the diagnosis and treatment of this disease.

Methods

The clinical data of a patient with pulmonary mucoepidermoid carcinoma were collected, and the clinical characteristics, diagnosis and treatment methods of pulmonary mucoepidermoid carcinoma were discussed based on the review of relevant literatures.

Results

The male patient aged 59 years old was admitted to the hospital because of “lung cancer discovered for more than 1 year and fatigue for 1 week”.The physical examination showed bilateral thoracic symmetry, no enhancement of speech tremor in both lungs, clear voice on percussion of both lungs, clear breath sounds on auscultation of both lungs, and no dry or wet rales. Based on the past history, a definitive diagnosis of pulmonary mucoepidermoid carcinoma was made. On admission, the chest CT results showed a mass shadow next to the mediastinum of the right upper lung with reduced density,the CT value was 29-43 Hu, blurred pleural margin, the size was 68 mm × 40 mm, the CT value after enhancement was about 73Hu in arterial phase, and the CT value was about 83 Hu in venous phase. Lymph node shadows were seen in the right hilum and mediastinum. Due to the previous operation, recurrence after chemotherapy, and unable to tolerate continued chemotherapy and targeted therapy, CT-guided argon-helium knife cryoablation was performed for the tumor in the right lung. The chest CT re-examination 1 month after the operation showed that the lesion was significantly reduced and the density was reduced. The value of CT was about 34 Hu, the size was 23 mm×26 mm, no obvious enhancement was seen after enhancement, and the right hilar and mediastinal lymph nodes were also smaller than before.

Conclusion

Pulmonary mucoepidermoid carcinoma is a special type of lung cancer with no obvious positive signs. High-grade pulmonary mucoepideromoid is prone to recurrence after surgery; the chemotherapy effect is poor, and there is no effective targeted drug therapy. Argon-helium knife cryotherapy can locally ablate the lesions, prolong the survival period,and improve the quality of life.

Key words: Lung neoplasms, Pulmonary mucoepidermoid carcinoma, Green treatment, Cryoablation, Imageology

中图分类号: 

  • R734.2