天津医药

天津医药 ›› 2020, Vol. 48 ›› Issue (5): 430-433.doi: 10.11958/20193243

• 临床研究 • 上一篇    下一篇

气管支气管腺样囊性癌的影像学、支气管镜及快速现场评价的特征分析 #br#

陶梅梅，张楠，邹珩，周云芝，马洪明，高鸿，王洪武△
  

  1. 应急总医院呼吸及危重症医学科（邮编100028）
  • 收稿日期:2019-10-24 修回日期:2020-03-12 出版日期:2020-05-15 发布日期:2020-06-24
  • 通讯作者: 王洪武 E-mail:wanghongwu2018@aliyun.com
  • 作者简介:陶梅梅（1981），女，博士，副主任医师，主要从事呼吸介入病学研究

The characteristics of imaging, bronchoscopy and rapid on-site evaluation in patients with primary tracheobronchial adenoid cystic carcinoma #br#

TAO Mei-mei, ZHANG Nan, ZOU Heng, ZHOU Yun-zhi, MA Hong-ming, GAO Hong, WANG Hong-wu△ #br#   

  1. Department of Pulmonary and Critical Care Medicine, Emergency General Hospital, Beijing 100028, China
  • Received:2019-10-24 Revised:2020-03-12 Published:2020-05-15 Online:2020-06-24

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摘要： 摘要：目的 分析原发性气管支气管腺样囊性癌患者的颈胸部 CT 和支气管镜下特征，并探讨快速现场评价
（ROSE）的细胞形态学特点及诊断准确率。方法 对 56例确诊的原发性气管支气管腺样囊性癌患者的临床资料进
行回顾性分析，所有患者均行颈胸部CT及全麻支气管镜下诊疗，获取标本进行ROSE及常规病理学检查。结果 从
CT表现来看，56例患者病变均发生在段及段以上支气管，局限性和弥漫性各28例，生长方式表现为腔内广基底型30
例（53.57%），管壁浸润型 18例（32.14%）和腔内外生长型 8例（14.29%）。支气管镜下可见病灶突入管腔呈偏心样狭
窄 38例（67.86%），黏膜弥漫性增厚呈环周样狭窄 18例（32.14%），病变表面较完整光滑，但表面血管丰富。ROSE可
见特征性的粉染基质球体和紫蓝染小肿瘤细胞同时存在，诊断准确率达 92.9%（52/56）。结论 原发性气管支气管
腺样囊性癌的CT和气管镜下表现具有特征性，ROSE诊断准确率高，可作为初步诊断的依据。

关键词: 气管, 腺样囊性癌, 支气管镜, 快速现场评价

Abstract: Objective: To investigate the CT and bronchoscopic characteristics of primary tracheobronchial adenoid cystic carcinoma, and to analyze the cellular morphologic features and diagnostic accuracy. Methods: A retrospective analysis was performed with 56 patients finally diagnosed primary tracheobronchial adenoid cystic carcinoma. All patients accepted chest CT scan and interventional bronchoscopy under general anesthesia．All patients were sampled for ROSE and pathological analysis. Results: Based on CT scan, the lesions of 56 patients located in trachea、main bronchus and segmental bronchus, were Abstract:Objective To investigate chest computerized tomography (CT) and bronchoscopic characteristics of primary
tracheobronchial adenoid cystic carcinoma (ACC), and to analyze the cellular morphologic features of rapid on-site
evaluation (ROSE) and diagnostic accuracy. Methods A retrospective analysis was performed with 56 patients diagnosed
as primary tracheobronchial adenoid cystic carcinoma. All patients accepted chest CT scan and interventional bronchoscopy
under general anesthesia．All patients were sampled for ROSE and pathological analysis. Results Based on CT scan, the
lesions located in trachea, main bronchus and segmental bronchus in 56 patients. The lesions were classified into localized
(28/56) and diffused (28/56) types. According to growing patterns, the lesions could be divided into three types: broadly basal
intraluminal nodules or masses (30/56), thickening type with infiltration along the wall (18/56) and intraluminal and outside
growing pattern (8/56). Bronchoscopic findings showed that eccentric constriction of the local lumens because of endoluminal
growth of ACC (67.86%) and circumferential stenosis because of diffuse thickness of mucosa (32.14%). The surface of the
lesion was smooth, but the surface blood vessels were abundant. ROSE showed that there were characteristic pink staining
spheric matrix and purple blue staining tumor cells at the same time. The diagnostic accuracy of ROSE was 92.9% (52/56).
Conclusion The CT and bronchoscopic features of primary tracheobronchial adenoid cystic carcinoma are characteristic,
and the accuracy of ROSE is high, which can be used as the basis for preliminary diagnosis.

Key words: trachea, adenoid cystic carcinoma, bronchoscopy, rapid on-site evaluation

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