摘要
目的:总结11例原发性颈段气管肿瘤的临床资料及诊治经验,提高对该类疾病的认识。方法:回顾性分析从1984年1月至2006年11月我院诊治的11例原发性颈段气管肿瘤患者的临床资料。恶性者共有9例,其中腺样囊性癌3例,鳞状细胞癌3例,粘液表皮癌1例,透明细胞癌2例。良性者2例,平滑肌瘤和神经纤维瘤各1例。结果:中位年龄为47.5岁(1.5～63岁)。呼吸困难和咳嗽咳痰是最多见的症状,有7例患者早期被误诊(63.6%)。纤维喉镜、纤维支气管镜或气管镜检查为确诊的重要手段。行手术治疗者8例,其中行气管袖状切除者2例,部分气管壁切除者3例,全喉、部分气管及甲状腺腺叶切除者1例,内窥镜下YAG激光切除者1例,气管开窗肿瘤剔除术1例。恶性肿瘤患者3年和5年生存率分别为72.9%和43.8%,而良性肿瘤患者均术后无瘤生存。姑息性放疗或化疗者3例,2例均于3年内死亡。手术治疗的并发症发生率为37.5%(3/8),主要为气胸和声音嘶哑。结论:原发性颈段气管肿瘤较少见,早期易误诊,应重视早期诊断。恶性者居多,最多见的是腺样囊性癌和鳞状细胞癌。手术是主要的治疗手段,气管袖状切除端端吻合术是得到广泛认可的理想术式,而单纯放疗或化疗效果均不理想。
Objective： To summarize our experience in diagnosing and treating 11 patients with primary tumor of the cervical trachea. Methods： We retrospectively reviewed the data from 11 patients with primary tumor of the cervical trachea seen in our hospital from January 1984 to November 2006. Nine patients were found to have malignant tumors, including 3 cases of adenoid cystic carcinoma, 3 cases of squamous cell carcinoma, 1 case of mucoepidermoid carcinoma, and 2 eases of transparent cell careinoma. Two patients were found with benign tumors： 1 with leiomyoma and the other with nerofibroma. Results： The median age of these patients was 47.5 years （1.5-63）. The most common symptom was dyspnea and cough with expectoration. Seven patients （63.6%） were misdiagnosed in the early stage of the disease. Surgeries were performed in 8 patients, including sleeve tracheal resection in 2 patients, partial tracheal wall resection in 3 patients, total laryngeetomy and partial excision of the trachea with thyroid lobectomy in 1 patient, and endoscopic YAG laser surgery in 1 parle,at. The overall 3-year and 5-year survival rates of the patients with malignant tumor were 72.9% and 43.8%. respectively. Both of the patients with benign tumors smwived disease-free during the follow-up period. Three patients underwent palliative irradiation or chemotherapy： two of those 3 patients died within 3 years. The incidence rate of postoperative complications was 37.5%（3/8）, and the main complications were pneumnthorax and hoarseness. Conclusion： Primary tumors of the cervical trachea, most of which are malignant, ate, extremely rare. Early diagnosis is critical. The most common histological subtypes were squamous cell carcinoma and adenoid cystic carcinoma. Surgery re,nains the prefene＇d treatment. Tracheal sleeve resection with end-to-end anastomosis is a well-tolerated and effective procedure. Chemotherapy or radiotherapy alone can not achieve satisfactory effects.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2008年第4期181-183,共3页
Chinese Journal of Clinical Oncology
关键词
原发性肿瘤
颈段气管
诊断
袖状切除
Primary, tumor
Cervical trachea
Diagnosis： Sleeve resection
