Bronchioloalveolar Carcinoma In 184 Cases Of Clinical Analysis

Background & Objective:Bronchioloalveolar cell carcinoma(BAC) was defined by the WHO in 1999 to be a subtype of pulmonary adenocarcinoma with unique pathological and radiological features.In recent years,there has been a profound increase in the incidence of BAC.It was reported that the complete response (CR) of some advanced BAC patients had been prolonged by the epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKI).This study is intended to investigate the clinical symptoms,diagnoses and misdiagnoses,pathological and radiological characteristics,treatment modes and prognoses of BAC.Methods:Retrospectively analyze the clinical data of 184 patients of BAC who were admitted by Peking Union Medical College Hospital(PUMCH) from January, 1990 to December,2005,using statistical methods.Results:The cases of this study account for 5.2%(184/3534) of primary bronchiogenic carcinomas and 14.5%(184/1265) of pulmonary adenocarcinomas that were admitted by PUMCH during the same period.The ratio of males to females is 1:1.24.BAC could easily be misdiagnosed as pneumonia,pulmonary tuberculosis or interstitial lung disease,and the percentage of the misdiagnosed cases is 57%.The median overall survival(OS) is 6.48 years(77.76 months).Survival is correlated with gender,clinical stage,pathological type,radiological type,and treatment mode(P＜0.05=.The three factors that would influence prognosis include pathological type, radiological type and treatment mode.Conclusion:BAC has distinctive characteristics as compared with other NSCLCs.In this study group,the incidence of BAC in females is similar to males. Bronchorrhea is not commonly seen in BAC;however,it may provide certain clues for diagnosis.Because of the radiological diversity,BAC could so easily be misdiagnosed that the treatment may be delayed.Still,it has relatively longer overall survival than other NSCLCs.Combined-modality therapy,which integrates surgery as the primary treatment method,chemotherapy,radiotherapy,and molecular targeted therapy,should be the principle for BAC treatment.EGFR-TKI could be used in advanced BAC as first-line treatment.