The Clinical Research Of Primary Bronchial Mucous Epidermoid Carcinoma

Objectives:Mucoepidermoid carcinoma is dominant in salivary glands, and rarely occurs in lung. Primary pulmonary mucoepidermoid carcinoma is one type of non-small cell lung cancer, but the optimal treatment remains controversial. The purpose of this investigation was to review the cases of pulmonary mucoepidermoid carcinoma. We analyzed the prognosis and discussed treatment strategy.Methods:A cohort of21patients with pathologically proven pulmonary mucoepidermoid carcinoma was included in the investigation. The patients presented at Zhongshan Hospital of Fudan University, and the cases accounted for0.69%of all resected pulmonary neoplasm in that period. There were10male (47.6%) and11female (52.4%) patients, and their average age was43.4years, range14-73years. Clinical features, treatment, expression of EGFR/HER2and prognosis were retrospectively studied.Results:Thirteen patients presented cough, and pulmonary occupying lesion was dominant in18patients, and some were accompanied with atelectasis or obstructive pneumonia. Fourteen patients received bronchoscopic examination, and2patients were diagnosed to be pulmonary mucoepidermoid carcinoma before surgery. All patients received operations, and lobectomy was the most common (13/21). After surgery,17tumors were diagnosed to be low grade and4tumors were high grade malignancy by pathology. One patient with low-grade tumor died perioperatively. Of the other16low-grade tumor cases, follow-up time ranged from5to77months (mean,46.6months), and1patient developed recurrence40months after surgery, and died one month later. Of the4high-grade tumor cases, follow-up time ranged from23to65months (mean,41.5months), and3patients died. Among the total21cases, expression rates of EGFR and HER2were28.6%and0, which were irrelevant with gender, smoke, grade, or survival. Age, grade, lymph node metastasis and TNM stage were associated with survival. Based on multivariate analysis, lymph node metastasis was significantly prognostic (Overall survival:Hazard ratio=0.06,95%CI:0.01-0.62, p=0.018; Progression-free survival:Hazard ratio=0.06,95%CI:0.01-0.61, p=0.017.)Conclusion:The preoperative diagnosis of pulmonary mucoepidermoid carcinoma relied on computer tomography and bronchoscopic examination. Because the clinical manifestations were untypical, it was difficult to get definite diagnosis before operation. Survival of patients with low-grade tumors was better than that of patients with high-grade tumors. Age, grade, lymph node metastasis and TNM stage were associated with survival, and lymph node metastasis was the prognostic factor.