支气管肺类癌的临床特点及预后因素分析

Diagnostic and Therapeutic Features of Bronchopulmonary Carcinoid

目的探讨支气管肺类癌,包括典型类癌(typical carcinoid,TC)及不典型类癌(atypical carcinoid,ATC)的临床特点及手术治疗经验,并分析可能的预后因素。方法回顾总结2000年1月至2014年1月在北京协和医院接受手术治疗并经病理检查证实为TC或ATC的57例患者临床资料,同时进行生存和预后分析。结果 57例患者中男性35例,女性22例,中位年龄49岁(12~85岁),中位病程3个月(1~156个月),临床症状缺乏特异性,12例伴有异位促肾上腺皮质激素综合征。术后病理确诊TC 39例,ATC 18例;Ⅰ期为主,共41例,Ⅱ期和Ⅲ期各7例,IV期2例。5年、10年存活率分别为92.4%及89.0%。Kaplan-Meier分析显示,病理类型、T分期及N分期的P值分别为0.001、0.000、0.004。结论支气管肺TC及ATC缺乏特异性临床表现,手术效果良好,病理分型、肿瘤T分期和N分期可能是预后的影响因素。

Objective The aim of this study was to evaluate the clinical features and the surgical experience of patients with bronchopulmonary carcinoids,including typical carcinoid（ TC） and atypical carcinoid（ ATC）,and to analyze the potential prognostic factors. Methods From January 2000 to January 2014,the clinical data of 57 consecutive cases of bronchopulmonary undergoing surgical resection and confirmed as TC or ATC by pathology in Peking Union Medical College Hospital were retrospectively analyzed; survival and prognostic analysis were also performed. Results There were 35 males and 22 females. The median age was 49（ 12-85） years old,and the median duration of disease was 3（ 1-156） months. Clinical symptoms lack specificity,and 12 cases got ectopic adrenocorticotropic hormone syndrome. The postoperative pathological examination confirmed 39 cases of TC and 12 cases of ATC; staging consisted of 41 cases of stageⅠ,7 stageⅡ,7 stage Ⅲ,and 2 stage Ⅳ. The 5-year and the 10-year survival rates were 92. 4% and 89. 0%,respectively. Kaplan-Meier analysis showed that the P values of pathological type,T stage and N stage were 0. 001,0. 000 and 0. 004,respectively. Conclusions The clinical features of bronchopulmonary TC and ATC are atypical and these patients have a preferably prognosis after surgery.Pathological types,T stages,and N stages might be the prognostic factors.