48例肺类癌患者的临床特征及预后分析

Clinical characteristics and prognostic analysis of 48 cases of pulmonary carcinoid

目的分析肺类癌(PC)患者的临床资料,提高对PC的认识。方法收集48例PC患者的临床资料,并对性别、年龄、吸烟史、病理类型、肿瘤大小、N分期、远处脏器转移和TNM分期等与PC患者预后的关系进行分析。结果 48例PC患者中,典型类癌(TC)30例,不典型类癌(AC)18例;临床表现以咳嗽、痰中带血为主;37例患者行手术治疗,11例患者行姑息性放化疗或对症支持治疗。48例PC患者的1、3、5年生存率分别为87.5%、83.3%、77.1%。单因素分析结果显示,不同病理类型、N分期、远处脏器转移、TNM分期PC患者的中位总生存期比较,差异均有统计学意义(P﹤0.05);多因素分析结果显示,TNM分期是PC患者总生存期的独立影响因素(P﹤0.01)。结论 PC的临床表现缺乏特异性,确诊主要依据术后病理。手术切除为PC的主要治疗手段,TNM分期是PC患者预后的独立影响因素。术后辅助化疗在PC治疗中的地位有待进一步确认。

Objective To analyze the clinical data of pulmonary carcinoid (PC) and improve the understanding of PC.Method The medical records of 48 patients with PC were collected.The relationships between prognosis of patients and sex,age,smoking history,pathological type,tumor size,N stage,distant organ metastasis and TNM stage were analyzed. Result Among of the 48 patients,30 and 18 patients were confirmed as typical carcinoid (TC) and atypical carcinoid (AC),respectively.The main clinical manifestations of PC are cough and bloody sputum.Thirty-seven patients underwent surgery,and 11 patients received palliative radiotherapy/chemotherapy or supportive treatment.The survival rates for 1-,3-and 5-year were 87.5%,83.3% and 77.1%,respectively.Univariate analysis indicated that there were significant differences in the median overall survival among patients with different pathological type,N stage,distant organ metastasis and TNM stage (P<0.05);whereas the multivariate analysis showed that the TNM stage was the only independent factor affecting the total survival of PC patients (P<0.01).Conclusion PC has no special clinical characteristics and the diagnosis depends mainly on postoperative pathology.Surgery remains the optimal treatment for patients with PC,TNM stage is confirmed to be the independent prognostic factor.The status of postoperative adjuvant chemotherapy remains to be further studied.