肺结节性病变-肺腺癌病理新进展
New pathological progress of lung adenocarcinoma in pulmonary nodular lesions
易伟强 1吴艺根 1伊雪2
作者信息
- 1. 厦门医学院附属第二医院胸心外科厦门医学院呼吸疾病研究所,厦门 361021
- 2. 厦门医学院基础部病理解剖教研室,厦门 361023
- 折叠
摘要
肺结节性病变包括良性和恶性肺结节.肺腺癌是恶性肺结节中最常见的一种类型.肺腺癌包括前驱腺体病变、微浸润性腺癌、浸润性黏液腺癌和非黏液腺癌,病理学亚型不同,其手术方式及预后也不尽相同.目前认为肿瘤肺泡腔内播散及亚型中微乳头成分和实性成分的占比直接影响外科手术方式及预后.故本研究提出对于前驱腺体病变可以楔形肺切除;微浸润性腺癌可以亚肺叶切除;浸润性腺癌需肺叶切除加淋巴结清扫.即使是la期的肺腺癌患者,如果含有肺泡腔内播散、微乳头、胸膜侵犯成分亦推荐术后辅助治疗.
Abstract
Pulmonary nodular lesions include benign and malignant pulmonary nodules.Lung adenocarcinoma is the most common type of malignant pulmonary nodules.Lung adenocarcinoma includes precursor gland lesions minimally invasive adenocarcinoma,invasive mucinous adenocarcinoma and invasive non mucinous adenocarcinoma.The surgical methods and prognosis vary depending on the pathological subtypes.At present,it is proposed that the proportion of micropapillary,solid components in tumor alveolar dissemination and subtypes directly affect surgical methods and prognosis.Therefore,this article proposes that wedge lung resection can be performed for precursor glandular lesions.Subpulmonary lobectomy can be performed for minimally invasive adenocarcinoma.Invasive adenocarcinoma requires lobectomy and lymph node dissection.Even if patients with stage la lung adenocarcinoma who contain solid components in tumor alveolar dissemination,micropapillary,and pleural invasion components are recommended for postoperative adjuvant treatment.
关键词
肺结节性病变/恶性肺结节/肺腺癌/病理分型/预后/外科手术Key words
Pulmonary nodular lesions/Malignant pulmonary nodule/Lung adenocarcinoma/Pathological classification/Prognosis/Surgical operation引用本文复制引用
出版年
2024
NETL
NSTL
万方数据