肺癌心脏转移诊断与外科治疗分析

Diagnosis and surgical treatment of cardiac metastases from lung cancer

目的:探讨肺癌心脏转移的临床特点及手术治疗效果。方法:回顾性分析2001年8月至2011年8月诊治的16例肺癌心脏转移患者的临床资料,包括临床表现、肿瘤性质、治疗经过和治疗效果等。结果:心血管系统症状为首发的16例肺癌心脏转移患者临床表现主要为:心力衰竭(93.75%),心包积液(68.75%),心律失常(43.75%)。PET-CT术前检出7例淋巴结转移。无手术死亡病例,术后生存中位时间11个月。分析表明病人术后生存期与年龄、是否根治性切除、肺切除范围、有无淋巴结转移、肿瘤侵犯部位、及是否行术前新辅助化疗相关(P<0.05),手术治疗能明显改善患者心功能。结论:对于心血管系统症状为首发的心脏肿瘤病人,应常规行PET-CT。选择正确的病例和彻底切除肿瘤,结合术前新辅助化疗能延长术后生存时间。手术治疗可改善患者的生活质量,对提高远期生存率意义不大。

Objective： To investigate the clinical characteristics and outcomes of surgical treatment of cardiac metastase from lung cancer. Methods： 16 patients with cardiac metastases were analysed through retrospective analysis,whom underwent surgical treatment from august 2001 to august 2011 in cardiovascular surgery department of the first affiliated hospital of zhengzhou university. Results： The chief clinical features were heart failure（93.75%）,pericardial effusion（68.75%） and arrhythmia（43.75%）.7 cases of lymph node metastasis were diagnosed through the PET-CT.The median survival period was 11 months.Significant survival factors（P〈0.05）demonstrated by univariate analysis included age,margin,the area of lung resection,lymph node metastasis,invading sit,neoadjuvant chemotherapy.Surgical treatment could improve the cardiac function of patients with cardiac failure. Conclusion： PET-CT should be a routine preoperative examination.Neoadjuvant chemotherapy,strictly selecting case and complete resection will prolong the postoperative survival period.Surgical treatment could improve the QOL in patients,but it could not improve the prognosis.