A Retrospective Clinical Analysis Of 32 Cases Of Primary Pulmonary Mucinous Adenocarcinoma

Objectives The aim of this study is to highlight the recognition of this kind of disease by analysis of clinical characteristic, radiological, pathologic characteristic diagnosis, treatment and prognosis of 32 cases of primary pulmonary mucinous adenocarcinoma (PPMA). Methods The detail of 32 cases of PPMA treated at the affiliated Union Hospital of Fujian Medical University was retrospectively analyzed, and reviewed relative literature.Results Among the 32 patient(sLung adenocarcinoma patients in the same period accounted for 3.65%,32/877), there were 20 male and 12 female with a mean age of 55.8±11.5(ranging from 29 to 76 years). 11 cases of patients with discomfort, found lungs occupying in physical examination and hospitalized, the remaining 21 cases have clinical manifestations, The major clinical symptoms includes fever, coughing, Chest pain, chest tightness, shortness of breath, headache and dizziness. The course of disease is about 3 days to 12 years(M=2months).All patients have recepted thoracic CT examination, A range of findings have been described on CT in PPMA, including tumor-like mass, patchy air-space conlidation, multifocal nodular appearances, cavitation, pleural thickening, pleural diffusion ,and/or mediastinal lymphadenopathy, maximum performance is of irregular or class circular mass, mild strengthening, light lobulated burr, accompanied by pleural indention in. 25 cases of patients with tumor markers increased insignificantly in the whole course. The method of final diagnosis: 28(28/32) patients identified by surgery, among the 28 cases, there are 9 cases of Thoracic surgery, and 19 cases of VATS. 1(1/32) patient was identified diagnosis by CT guided Percutaneous cutting needle biopsy(PCNB), 1 (1/32) patient was finally identified by bronchofibroscope,1(1/32)patient was identified by left supraclavicular node biopsy,1(1/32) patient was identified by fine needle aspiration (FNA) cytological practice in the left shoulder masses. Of these 32 patients, 9 were in stage TNMⅠ,3 in stage TNMⅡ,8 in stage TNMⅢand 12 in stage TNMⅣ. 8 patients give up chemo-radiotherapy after diagnosis, the rest receive 4-6 cycles of simple chemotherapy, or combined with Radiotherapy or/and gamma sabre or/and targeting drug therapies.18 patients are alive and well while 9 died of the disease with metastasis to intrapulmonary, pleura, bone, brain, liver, right adrenal. One had postoperation brain metastasis recurrence in 3 month, and appeared Horner syndrome. 3 patients is receiving oral targeted drug therapy. The other 4 is losing. Conclusion PPMA are mostly peripheral lung cancer, no specific (typical) clinical manifestations and imaging findings and the only confirmed method is pathological examination; Immunohistochemistry examination not only can determine the origins of mucinous may also help prognostic judgement; it is necessary to have histochemistry examination of the pathology of PPMA patients routinely; the patients with high rish factors of pulmonary occupying, tumor makers increase and middle-aged should diagnosis and treat early; VATS can diagnose and treat PPMA safely, effectively, accurately; Early PPMA have favorable prognosis with early diagnosis and treatment, but advanced PPMA have poor prognosis with metastasis to intrapulmonary, pleura, bone, brain, liver, right adrenal and thyroid; PPMA may transfer by lymph primarily; because of heterogeneity of PPMA, it should be treated individually according to pathology and condition.