胸腺癌

A Retrospective Analysis of 14 Cases of Thymic Carcinoma

对外科手术及病理证实的１４例胸腺癌进行回顾性分析，旨在提高对胸腺癌临床表现、诊断方法和外科处理的认识。大多数胸腺癌病人表现有胸痛或胸部不适等非特异性症状，但不合并胸外综合征。胸腺癌肿瘤较大、多侵犯周围脏器，手术切除率低。本组２例肿瘤完整切除，７例部分切除，５例行开胸探查，无手术死亡。除胸内广泛浸润外，胸腺癌常发生胸外转移，故预后很差。１４例术后均行辅助治疗，死亡１０例；其中５例于术后１年内死亡，３例死于术后２年，另２例分别于术后５、８年死亡；现生存４例。作者强调胸腺癌比胸腺瘤恶性程度高，预后差，应早期诊断，彻底手术切除；术后辅以放疗和化疗，以提高治疗效果。

This paper aims at improvement of understanding of the clinical manifestations,diagnostic methods,surgical management and postoperative adjuvant therapy of thymic carcinoma through retrospective analysis of 14 such cases treated surgically and confirmed by pathological examination.Most cases had nonspecific symptoms of chest pain and discomfort,but none accompanied with extrathoracic syndrome.The tumor is always large in size and frequently invades the neighbouring organs,hence its resection rate is low.In this series,complete excision was accomplished in only 2 cases,partial resection in 7,and 5 patients had only exploratory thoracotomy.There was no operative death.Besides,ten developed extrathoracic metastases.Therefore,thymic carcinoma patients have poor prognosis.In this series,14 patients had postoperative adjuvant therapy,10 of the 14 died,5 within the first postoperative year,3 within 2 years,1 within 5 and 1 within 8.Four patients are still alive at present.Emphases are placed on early diagnosis,thorough surgical resection and postoperative adjuvant therapy in order to improve the result of treatment.