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左上肺腺癌合并左下肺鳞癌病例分析

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肺癌在我国的发病率及死亡率位居前列.现代技术手段及治疗方式的不断进步使得肺癌的早期诊断及治疗水平有了明显提高.多原发性肺癌(multiple primary lung cancer,MPLC)是指同一患者一侧肺或双侧肺内先后或同时发生2处或2处以上原发性恶性肿瘤,并且相互独立.根据发病时间,以6个月为界,多原发性肺癌分为同时性多原发性肺癌与异时性多原发性肺癌.对于多原发性肺癌的诊断,可通过影像学方法进行初步筛查,组织病理学检查是诊断的金标准.目前对于多原发性肺癌的鉴别诊断及治疗方法临床暂无统一标准.本研究所报道的病例术后病理报告为左上肺腺癌,左下肺鳞癌,提示在临床中肺部多发结节不能单纯靠"一元论"来解释,认为其是肺癌转移瘤的可能性大,应尽早明确病理诊断,制定最佳的治疗方案,从而实现多原发性肺癌的早期诊断、早期治疗.
Case Analysis of Left Upper Lung Adenocarcinoma Complicated with Left Lower Lung Squamous Cell Carcinoma
The incidence and mortality rate of lung cancer is high in China.With the continuous progress of modern technology and treatment methods,the early diagnosis and treatment of lung cancer have been significantly improved.Multiple primary lung cancer(MPLC)refers to the occurrence of two or more primary malignant tumors in one or both lungs of the same patient successively or simulta-neously,and which is independent of each other.According to the onset time,MPLC is divided into synchronous multiple primary lung cancer and metachronous multiple primary lung cancer.For the diagnosis of MPLC,imaging can be used for initial screening,and histo-pathological examination is the gold standard for diagnosis.At present,there is no unified standard for the differential diagnosis and treat-ment of MPLC.The postoperative pathological report of the case reported in this study was adenocarcinoma of the left upper lung and squamous cell carcinoma of the left lower lung,which suggested that multiple pulmonary nodules cannot be explained by"monism"in clinical practice,and simplythink that it may be metastatic tumor of lung cancer.Pathological diagnosis should be made as soon as pos-sible to make the best treatment plan,so as to realize the early diagnosis and treatment of MPLC.

Multiple primary lung cancerSquamous cell carcinomaAdenocarcinomaMonism

谷鑫月、陆辉辉

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湖南中医药大学,湖南 长沙 410000

湖南省直中医医院外科,湖南 株洲 412000

多原发性肺癌 鳞癌 腺癌 一元论

2024

中国医药导刊
国家食品药品监督管理局信息中心

中国医药导刊

影响因子:1.408
ISSN:1009-0959
年,卷(期):2024.26(5)