肺癌肉瘤的诊断和外科治疗

Diagnosis and surgical treatment of pulmonary carcinosarcoma

目的探讨肺肉瘤的临床病理特征,诊断、鉴别诊断和合理外科治疗方法。方法回顾我院1980～2008年间收治的21例肺肉瘤患者的临床资料,并结合文献分析。结果 21例患者中,男17例,女4例;年龄19～71岁,平均49.1岁;主要临床症状包括咳嗽、咳痰、痰中带血和胸痛,周围型15例,中央型6例;全组19例手术治疗,术前均误诊,手术切除率为100%,术中和术后住院期间无死亡,并发症发生率为26.3%(5/19)。术后病理检查证实肺癌肉瘤,5年生存率为23.8%(5/21)。结论肺癌肉瘤术前易被误诊,早期诊断和外科治疗是关键,手术指证及术式选择应根据患者具体情况而定。

Objective To explore the clinical and pathologic characteristics,diagnosis,differential diagnosis,and rational surgical treatment of primary pulmonary sarcoma. Methods The clinical data of 21 patients in primary pulmonary sarcoma from 1980 to 2008 were retrospectively analyzed and the literature was reviewed. Results In 21 patients, 17 patients were male,4 were female. Their age ranged from 19 to 71-year-old （mean 49. 1-year-old）. Main clinical symptoms included cough, expectoration, hemoptysis, and chest pain. By chest X plain and CT scan ,lesions of 15 patient belonged to peripheral type carcinoma of lung, and 6 patients belonged to central type carcinoma of lung. All of patients misdiagnosed preoperatively. 19 patients underwent surgical procedure. The rate of surgical resetting was 100%. There is no death within intraoperation and postoperative hospital days. The rate of complications was 26. 3%. All patients confirmed palmonary by means of postoperative pathologic examination. The 5-year survival rate was 23.8%. Conclusion Pulmonary can be easily misdiagnosed before operation. Therapeutic crucial lies in early diagnosis and surgical treatment. The operative indications and approaches should be depended on the patient＇s situation.