摘要
报告１８例支气管类癌的临床和外科手术治疗结果，旨在提高对支气管类癌及其合并症的认识，选择合适的手术方法，分析影响预后的各种因素。施行肺叶切除１０例，楔形切除３例，支气管腔内肿瘤摘除３例，开胸探查２例，无手术死亡或住院死亡。病理报告１４例为典型支气管类癌，４例系不典型支气管类癌。经２～１３年随诊，术后３、５和１０年存活率分别为８２％、７８％和７０％。支气管类癌常被误诊，确诊需光镜、电镜或免疫组织化学检查。合并柯兴综合征的类癌手术效果好。依肿瘤的病理类型、部位、病人的心肺功能决定手术方式。不典型支气管类癌恶性程度高，预后差。肿瘤的部位、有无淋巴结转移、以及术后是否辅助治疗，对病人的长期存活似乎没有明显影响。决定预后的因素是肿瘤的病理类型、发现的早晚和适当的外科手术。
Purpose:To study the effect of surgery and the factors affecting prognosis in patients with bronchial carcinoid.Materials and methods:18 cases of carcinoid tumor are presented.There were lobectomy in 10 cases,lung wedge resection in 3, excision of intraluminal tumor of bronchus in 3, exploratory thoracotomy in 2.Results:No operative death.Pathological examination revealed typical carcinoid in 14 and atypical in 4. By 2～13 year follow-up,3,5 and 10 year survival were 82%,78%and 70% respectively. Bronchial carcinoid is often confused with small cell carcinoma of lung. A correct diagnosis can be obtained by light microscopic,electron microscopic and immunohistochemical studies. Those patients with ectopic-ACTH secretion alyways have Cushing's syndrome and resection of the tumor yields good results. Conclusion:Choice of proper operative procedure and extent of resection depend on the location of the tumor and the cardiopulmonary reserves of the patient.Atypical carcinoid is of high malignancy with poor prognosis. The size of tumors, lymph node involvement and adjuvant therapy seem to have no definite effect on the patient's survival rate, Pathological classification,stage of the tumor,and the appropriate surgical treatment are important factors affecting prognosis.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
1996年第6期342-344,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
支气管类癌
小细胞肺癌
外科手术
预后
Bronchial carcinoid Surgical treatment Cushing's syndrome
