Clinical Analysis Of20Patients With Bronchioloalveolar Carcinoma

ObjectiveBronchiolalveolar carcinoma(BAC) which has unique epidemiology, pathology, radiology and clinical features is a subtype of lung adenocarcinoma. This article aims to explore the clinical characteristics of BAC and improve the diagnosis and treatment.MethodsWe retrospectively analyzed the clinical date of20BAC patients who were admitted to The Second Affiliated Hospital of Zhengzhou University from April2007to April2009. We combined with published literature to summarize the clinical features of BAC, and make a statistical analysis.ResultsThe ratio of males to females was1:1.5in20BAC patients. The median age was57years. The proportion of never smokers was20%, all of women were never smokers. First symptoms were cough, spitting, hemoptysis, chest pain and dyspnea.6patients(30%) had a history of misdiagnosis before operation, all of them were misdiagnosed as lung infections. There were three major radiographic patterns: solitary pulmonary nodule(n=11), localized consolidation(n=8), and diffuse disease(n=1). Only4patients showed pathologic stage I, The other stages were11(7),111(8), and IV(1). Lobectomies was performed in17patients, pueumonectomies in14, and except1explorative thoracotomy, all of them had lymph node dissections. No perioperative death occurred. Follow-up to March2012, the overall follow-up rate was90%. The range of survival time was from9months to52months. The median survival time was29months, The1-,2-and3-year survival rates were78.9%,57.9%,28.1%.ConclusionThe survival rate was significantly lower than that reported in the literature, it may be connected with small sample size, date bias and pathological diagnosis. Univariate analysis revealed that N2group lymph node metastasis were statistically significant factors affecting survival, while gender is not. Most patients before operation can’t obtain the BAC pathological evidence. Surgical treatment is the first choice of BAC therapy.