CAJ | 학술논문

目的提高临床医师对肺癌伴类白血病反应(leukemoid reaction,LR)的认识,减少漏诊、误诊.方法报道中南大学湘雅二医院呼吸内科2011年10月收治的1例肺癌并嗜酸粒细胞型LR,对国内外文献共报道的55例肺癌伴LR的临床症状、外周血象、骨髓学特征、治疗及预后进行分析.结果国内共报道了16例肺癌伴LR,国外近10年共统计和报道了39例肺癌伴LR.55例LR中仅3例为嗜酸粒细胞型,50例为中性粒细胞型,2例未报道具体类型.以“肺癌”和“类白血病反应”为主题词检索中国期刊网全文数据库,结果有相关文献12篇,共报道16例肺癌合并LR,有13例取得肺癌病理组织类型,14例行骨髓学检查.以“lung cancer”和“leukemoid reaction”加时间限制“10 years”在Pubmed里可检索到6篇相关文献,共统计39例肺癌并LR,均取得肺癌病理类型及骨髓学结果.以“lung cancer”和“eosinphil”为主题词检索Pubmed,无相关报道.结论肺癌合并嗜酸粒细胞型LR尚属罕见.LR一般发生在肿瘤晚期,骨髓检查对其诊断很重要,一旦出现提示疾病预后差,大多在1～6个月内死亡.
목적 제고림상의사대폐암반류백혈병반응(leukemoid reaction,LR)적인식,감소루진、오진.방법 보도중남대학상아이의원호흡내과2011년10월수치적1례폐암병기산립세포형LR,대국내외문헌공보도적55례폐암반LR적림상증상、외주혈상、골수학특정、치료급예후진행분석.결과 국내공보도료16례폐암반LR,국외근10년공통계화보도료39례폐암반LR.55례LR중부3례위기산립세포형,50례위중성립세포형,2례미보도구체류형.이“폐암”화“류백혈병반응”위주제사검색중국기간망전문수거고,결과유상관문헌12편,공보도16례폐암합병LR,유13례취득폐암병리조직류형,14례행골수학검사.이“lung cancer”화“leukemoid reaction”가시간한제“10 years”재Pubmed리가검색도6편상관문헌,공통계39례폐암병LR,균취득폐암병리류형급골수학결과.이“lung cancer”화“eosinphil”위주제사검색Pubmed,무상관보도.결론 폐암합병기산립세포형LR상속한견.LR일반발생재종류만기,골수검사대기진단흔중요,일단출현제시질병예후차,대다재1～6개월내사망.
Objective To analyze the clinical presentations of lung cancer with leukemoid reaction (LR) and to improve the clinical doctors' understanding of lung cancer with LR to reduce misdiagnosis.Methods Clinical symptoms,peripheral blood,treatment,and prognosis of one patient with lung cancer with LR in our department and 55 patients reported in literatures were analyzed.Results Through searching China journal full-text database using "lung cancer" and "leukemoid reaction" as subject terms,there were 16 patients of lung cancer with LR reported since 1989.And through searching Pubmed using the same subject terms with restricting of 10 years,there were 39 patients of lung cancer with LR reported.52 of 55 patients were diagnosed by lung biopsy,and 53 of 55 patients were diagnosed by bone marrow biopsy.There was no literature reported searching Pubmed using "lung cancer" and "eosinphil".LR mainly occured in the advanced state of disease.LR should be diagnosed with bone marraw examination.Conclusions LR commonly occurs in later period of cancer,disease prognosis is poor once appears,mostly dying in 1-6 months,especially in patients of lung cancer with LR.Most lung cancer with LR is the type of neutrophils,and lung cancer with eosinophil LR is reported rarely up to now.