原发性支气管黏液表皮样癌的外科治疗与预后

Surgical treatment and prognosis of bronchial mucoepidermoid cancer

目的分析黏液表皮样肺癌的外科治疗及效果。方法回顾总结本科17年间19例手术切除的原发性肺黏液表皮样癌,分析其临床病理特征和外科治疗效果。结果全组均行手术治疗,占同期手术切除肺癌的0.68%。肺叶切除术13例,全肺切除5例,开胸探查1例。15例为低恶性,4例高恶性。术后平均随访68.26个月,无失访,1、3、5年生存率分别为94.44%(17/18)、80.00%(12/15)和70.00%(7/10)。其中低恶性占78.95%(15/19),均无淋巴结转移,1、3、5年生存率均为100%;高恶性4例,淋巴结转移率75%(3/4),1年生存率为33.33%,无3年生存率。结论原发性支气管黏液表皮样癌发病率低。病理以低恶性为主。低恶性黏液表皮样癌经彻底手术切除可获治愈,高恶性病人术后易早期发生远处转移,预后差。

Objective To investigate the surgical treatment and prognosis of bronchial mucoepidermoid cancer. Methods During a 17-year-period, 19 consecutive patients underwent surgery for bronchial mucoepidermoid cancer, and the surgical treatment and prognosis were analyzed retrospectively. Results Among them, 13 cases were treated by lobectomy, 5 by pneumonectomy, and 1 by exploratory thoracotomy. Four cases were proved pathologically to be high malignancy and 15 low malignancy. All patients were followed up postoperatively for about 68.26 months on average. The 1,3, and 5-year survival rates were 94.44%, 80.00%, and 70.00% respectively. In the low malignancy group, the 1, 3, 5-year survival rates were 100% ; in the high malignancy group, the 1-year survival rate was 33.33%, and 3-year survival rate was 0. Conclusion Patients with low malignant grade of cancers can be cured after complete resection, and those with high malignant grade predispose to metastasis and hence result in a poor prognosis.