Clinicopathological Analysis of Primary Signet Ring Cell Adenocarcinoma of the Lung_West China Medical Journal

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Department of Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

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Keywords：

肺腫瘤; 癌，印戒細胞; 免疫組織化學; 診斷; 存活率分析; 預后

DOI：

10.7507/1002-0179.20130222

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目的　探討原發性肺印戒細胞腺癌（PSRCACL）的臨床病理學特點、診斷與鑒別診斷及其預后因素等。方法　收集2000年1月－2012年6月間50例PSRCACL患者的臨床資料，進行組織學及免疫組織化學檢測觀察，并進行隨訪和結合文獻復習分析。結果　 PSRCACL的臨床癥狀及影像學表現與非小細胞肺癌無明顯差異，其診斷與鑒別診斷依據其特殊的細胞形態學及免疫組織化學檢測。PSRCACL的發病率約占肺腺癌的1.20%，平均發病年齡為53.3歲，中位年齡為54.5歲，男女比例為1.17︰1。患者的中位生存時間約為56個月，1年生存率約為85.4%，3年生存率約為67.4%，5年生存率約為40.9%。患者的生存率與患者的性別、年齡無關（P＞0.05），與腫瘤的大小、是否伴有癌轉移及TNM分期有關（P＜0.05）。結論　PSRCACL是一種比較罕見的、好發于中青年人、惡性程度較高、易發生侵襲和轉移、預后較差的惡性上皮性腫瘤，除手術治療外，目前尚無標準化療方案。

Citation： HE Xin,LIANG Dongni,CAO Yidan,YE Yunxia,JIANG Lili,ZHANG Shangfu.. Clinicopathological Analysis of Primary Signet Ring Cell Adenocarcinoma of the Lung. West China Medical Journal, 2013, 28(5): 710-714. doi: 10.7507/1002-0179.20130222 Copy

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11.	楊柳青, 秦叔逵, 華海清．原發性右肺印戒細胞癌1例[J]．臨床腫瘤學雜志, 2005, 10(3): 335．.
12.	王琳, 張楚, 趙建華, 等．國人原發性肺印戒細胞癌伴EML4-ALK融合基因陽性1例[J]．臨床腫瘤學雜志, 2012, 17(4): 381-382．.

1. 　Tsuta K, Ishii G, Yoh K, et al. Primary lung carcinoma with signet-ring cell carcinoma components: clinicopathological analysis of 39 cases[J]. Am J Surg Pathol, 2004, 28(7): 868-874.
2. 　Shimosato Y, Suemasu K, Suzuki A. Morphology of bronchial gland tumors, with special reference to adenocarcinomas[J]. Gan No Rinsho, 1973, 19(2): 170-179.
3. 　Kish JK, Ro JY, Ayala AG, et al. Primary mucinous adenocarcinoma of the lung with signet-ring cells: a histochemical comparison with signet-ring cell carcinomas of other sites[J]. Hum Pathol, 1989, 20(11): 1097-1102.
4. 　Travis WD, Brambilla E, Müller-Hermelink HK, et al. Pathology and genetics of tumours of the lung, pleura, thymus and heart[M]. Lyon: IARC Press, 2004: 10.
5. 　Castro CY, Moran CA, Flieder DG, et al. Primary signet ring cell adenocarcinomas of the lung: Aclinicopathological study of 15 cases[J]. Histopathology, 2001, 39(4): 397-401.
6. 　Yoshida A, Tsuta K, Watanabe S, et al. Frequent ALK rearrangement and TTF-1/p63 co-expression in lung adenocarcinoma with signet-ring cell component[J]. Lung Cancer, 2011, 72(3): 309-315.
7. 　Wang YJ, Liu CT, Li HX, et al. A clinical study of 12 patients with primary signet ring cell carcinoma of lung and literature review[J]. Med J China PAPF, 2010, 21(4): 324-326.
8. 　Merchant SH, Amin MB, Tamboli P, et al. Primary signet-ring cell arcinoma of lung: immunohistochemical study and comparison with on-pulmonary signet-ring cell carcinomas[J]. Am J Surg Pathol, 2001, 25(12): 1515-1519.
9. 　Hayashi H, Kitamura H, Nakatani Y, et al. Primary signet-ring cell carcinoma of the lung: histochemical and immunohistochemical characterization[J]. Hum Pathol, 1999, 30(4): 378-383.
10. 　鄭玉龍, 丁偉, 周建英．原發性肺印戒細胞癌臨床表現[J]．浙江預防醫學, 2008, 20(5): 87-88．.
11. 　楊柳青, 秦叔逵, 華海清．原發性右肺印戒細胞癌1例[J]．臨床腫瘤學雜志, 2005, 10(3): 335．.
12. 　王琳, 張楚, 趙建華, 等．國人原發性肺印戒細胞癌伴EML4-ALK融合基因陽性1例[J]．臨床腫瘤學雜志, 2012, 17(4): 381-382．.

West China Medical Journal

Clinicopathological Analysis of Primary Signet Ring Cell Adenocarcinoma of the Lung

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