12例胸腺非典型类癌的临床分析

Clinical analysis of 12 cases of thymus atypical carcinoid

目的：探讨胸腺非典型类癌（thymus atypical carcinoid，TAC）的临床特点，为TAC的正确诊断和治疗提供资料及积累经验。方法收集1999年至2014年收治的12例TAC患者的临床和病理资料进行归纳分析，同时复习文献。结果12例患者的临床症状及体征无特异性，影像学检查可见前纵隔肿物。10例接受手术切除肿瘤，2例仅接受切取活检和穿刺活检。病理及免疫组化诊断为TAC。4例患者未接受辅助治疗，3例接受化疗，2例接受放疗，2例接受化疗联合放疗，1例接受同步放化疗。平均随访25.6个月（8～46个月），4例患者死于疾病进展（生存时间分别为10、25、39和40个月），3例发生肿瘤进展后仍存活（生存时间分别为43、44和46个月），4例获得无进展生存（生存时间分别为8、10、11和16个月），1例随访9个月后失访。结论 TAC是一种罕见的恶性肿瘤，影像学检查结合病理及免疫组化可予明确诊断，手术是首选的治疗方法，但患者的预后较差。

Objective To provide information for proper diagnosis and treatment for thymus atypical carcinoid （TAC） by investigating the clinical characteristics, diagnosis, treatment and prognosis of the disease. Method The retrospective analysis was performed on the data of 12 patients with TAC from 1999 to 2014 in our hospital, and re-lated literatures were reviewed. Result Although computed tomography scan of the thorax showed the mass, there were nonspecific symptoms and radiological findings in all the 12 patients. 10 of 12 patients received surgical resec-tion, and 2 patients had excisional biopsy or aspiration biopsy, of which the samples were confirmed as TAC with pa-thology and immunohistochemistry. After surgery, 4 patients had not received adjuvant therapy, 3 patients were admin-istered with chemotherapy, and 2 had radiotherapy, chemotherapy plus radiotherapy were performed in 2 and radio-chemical resynchronization therapy in 1. The mean follow-up time was 25.6 months （8-46 months）, during which 4 patients were found to be dead after tumor progression （survival time was 10, 25, 39 and 40 months, respectively）, 3 patients survived after tumor progression （survival time was 43, 44, 46 months, respectively）, 4 patients had tumor-free survival （survival time was 8, 10, 11, 16 months, respectively）, 1 patient lost to follow up after 9 months. Con-clusion TAC is a rare and often misdiagnosed disease. The useful method of diagnosis of TAC depends on the pa-thology combined with the immunohistochemistry after surgery. Resection is usually an effective means of cure but＆amp;nbsp;the prognosis may not be good.