原发性肺类癌47例临床治疗体会

Clinical analysis of 47 cases of primary pulmonary carcinoid tumor

目的探讨肺类癌的临床特点、治疗方法与预后。方法收集1998～2009年本院经手术病理证实的47例原发性肺类癌的临床资料，对其术前检查及术后的病理学检查结果、预后情况等进行分析。结果男31例，女16例。年龄26～68岁。28例为中央型，19例为周围型。32例行纤维支气管镜检查，其中22例行镜下活检。本组患者均行外科治疗。术后病理报告典型类癌28例，淋巴结转移率为21．4％；不典型类癌19例，淋巴结转移率为68．4％。随访截止至2009年10月，典型类癌5年生存率为82．5％；不典型类癌5年生存率为48．5％。结论肺类癌属低度恶性肿瘤，具有神经内分泌功能，可诱发类癌综合症，影像学表现以中央型肺癌多见。肺类癌以手术治疗为主，切除后预后良好。病理类型和有无淋巴结转移是影响肺类癌预后的两个重要因素，典型类癌预后好于不典型类癌。放化疗效果仍有争议。

Objective To summarize the clinical features of pulmonary carcinoid tumor and its treatment and prognosis. Methods We collected the clinical data of 47 cases of primary pulmonary carcinoid tumor confirmed pathologically in our hospital during 1998- 2009, and did an analysis based on the preoperative examination results, the pathological results and the prognosis. Results The 47 cases included 31 males and 16 females, with age ranging from 26 to 68 years, of which 28 cases were of central type and 19 cases of peripheral type. Thirty - two patients under- went routine fiberoptic bronchoscopy, and 22 did routine endoscopic biopsy. All patients were subjected to surgical treatment. Pathological examination results showed 28 cases of typical carcinoid tumor with lymph node metastasis rate of 21.4%, and 19 cases of atypical carcinoid tumor with lymph node metastasis rate of 68.4 %. The follow- up wound up in October 2009, and the results were that the 5 - year survival rate of typical carcinoid tumor was 82.5 % and that of atypical carci- noid tumor was 48.5 %. Conclusions Pulmonary carcinoid tumor is a low - grade malignant tumor with neuroendocrine function, and can induce carcinoid syndrome. In its imaging findings, central - type lung cancer is common. The pulmonary carcinoid tumor is usually managed surgically and its prognosis is good after the resection. Pathological type and lymph node metastasis are the two cru- cial factors influencing the prognosis of pulmonary cxrcinoid tumors. In term of prognosis, the typical carcinoid tumor is better than atypical carcinoid tumor. Its radiotherapy and chemotherapy remain controversial.