Retrospective Clinical Analysis Of Pulmonary Mucoepidermoid Carcinoma

ObjectivePulmonary Mucoepidermoid Carcinoma(PMEC)accounts for a low proportion of malignant tumors in the lung.Rports form domestic and foreign research institutions that refer to its incidences,clinical features,and risk factors that affect prognosis are different.By analyzing the medical records of 55 PMEC patients,summarizing their clinical features,exploring the risk factors that affected the prognosis of PMEC patients and reviewing the literature,we try to summarize appropriate treatments for PMEC.Methods55 medical records that were diagnosed as PMEC by surgical pathology were collected from January 2005 to December 2015 in the First Affiliated Hospital of Zhengzhou University.And the clinical manifestations,imaging features,pathological features,and treatment methods of the patients were collected.Statistical software SPSS was used to explore whether the patient’s features such as gender,age,smoking history,tumor diameter,TNM stage,differentiation,lymph node metastasis are related to patient prognosis.ResultsOf the 55 PMEC patients there were 34 male and 21 female and the average age of onset was 49.22 years.There were 21 smokers(38.2%).Ten patients were asymptomatic,and they were hospitalized because of a lung mass which was found by physical examination.The common clinical symptoms were cough,sputum,chest tightness,chest pain,fever,and bloody sputum.However hoarseness,hemoptysis,and dyspnea were rare.All of the patients underwent chest CT examination.The diameter of the tumor was 1.2-9.5 cm,and the median diameter was 5.0 cm.The imaging manifestations were diversity.The lesions were mostly nodular,patchy,clumpy with hilar enlargement,empty,Pleural thickening,mediastinal lymphadenopathy,etc,edge of the tumors were common with spicule sign,lobulation sign,pleural traction and blood vessel bundles.The TNM stage(International Anticancer Alliance,7th edition,2009)as follows: 21 cases(38.2%)in Phase I,5 cases(9.1%)in Phase II,and 29 cases(52.7%)in Phase III.The degree of differentiation as follows: poorly differentiated 38 cases(69.1%),follow-up time 5-77 months(mean 21 months),well-differentiated 17 cases(30.9%),follow-up time 25-115 months(average 61.3 months).There were 32 cases(58.2%)with lymph node metastases,and 23 cases had no metastasis.Treatment: 26 cases were operated on alone,and 29 patients received adjuvant chemotherapy after surgery.Among all the subjects,7 were lost to follow-up and 31 died.The deaths were common with mediastinal lymph node metastasis,metastasis within the lung,brain metastasis,bone metastasis,and adrenal metastasis.There was no significant correlation between gender,age,smoking history and prognosis in the univariate analysis of prognosis risk factors(P>0.05).Tumor diameter,TNM stage,differentiation and lymph node metastasis were related to postoperative survival(P values were 0.035,<0.001,<0.001,<0.001 respectively),multivariate COX regression analysis suggested that TNM stage,differentiation and lymph node metastasis were prognostic risk factors for PMEC(P values were 0.011,0.002,and 0.023,respectively)Conclusion1.PMEC is easily misdiagnosed and immunohistochemical examination is helpful for differential diagnosis and prognosis assessment of PMEC patients.2..TNM staging,tumor differentiation,lymph node metastasis are independent risk factors that affect the prognosis of PMEC patients.