支气管肺类癌的诊断和治疗

Diagnosis and treatment of bronchopulmonary carcinoid tumors

目的探讨支气管肺类癌的诊断和治疗原则。方法分析我院1975至2007年外科治疗的59例支气管肺类癌的临床特点、治疗方法及预后。结果59例患者中男37例,女22例。年龄26～72岁,平均47.6岁。45例为中央型,13例为周围型,位于气管1例。37例行纤维支气管镜检查,其中32例行镜下活检,13例术前明确诊断。本组患者均行外科治疗,根治性切除率93.2%。术后病理报告典型类癌41例,淋巴结转移率为9.8%;不典型类癌18例,淋巴结转移率为66.7%。本组38例随诊满5年以上,典型类癌5,10年生存率分别为100.0%和85.7%;不典型类癌5年生存率为53.8%。结论手术切除是治疗支气管肺类癌最有效的方法。此病预后较好,其中典型类癌预后好于不典型类癌。放化疗的作用不肯定。

Objective To explore diagnosis and treatment of bronchopulmonary careinoid tumors. Methods Fifty-nine patients with bronchopulmonary carcinoid were surgically treated in our hospital from 1975 to 2007 and their clinical features, treatments and survival were reviewed. Results Of the 59 patients, 37 were males and 22 were females. The median age was 47.6, ranging from 26 to 72. Forty-five primary tumors were located in the major bronchi, 13 in the periphery of the lung and 1 in the trachea. Bronchoscopy was performed for to 37 cases preoperatively, biopsy was conducted in 32 cases and correct pathological diagnosis was obtained in 13 cases. All of the patients received surgical treatment, the rate of radical operation was 93. 2%. Of the 59 patients, 41 were diagnosed as typical careinoids （TC） and 18 as atypical careinnoids （AC）. In the TC and AC groups, the rates of lymph-node metastases were 9. 8% and 66. 7% , respectively. Thirty-eight cases （ 25TC, 13AC） of this group were followed up for 5 years, the 5-and 10-year survival rates of TC were 100.0% and 85. 7% , respectively. The 5-year survival rate was 53.8% in AC group. Conclusion Surgical resection is the most effective treatment of bronchopulmonary carcinoid tumors. The prognosis is relatively good in TC, it is worse in AC. The role of radiotherapy and chemotherapy is still debated.