支气管镜介入技术治疗典型类癌的近期疗效及远期疗效观察

Observation of Short-term and Long-term Efficacy of Bronchoscopic Interventional Therapy in the Treatment of Typical Carcinoid

背景与目的支气管镜下的各种介入治疗技术包括圈套、二氧化碳冷冻、氩等离子体凝固(argon plasma coagulation,APC)、激光(Neodymium-dopted Yrium Aluminium Garnet,Nd:YAG)、光动力治疗(photodynamic therapy,PDT),以上治疗技术通常用于治疗气管腔内肿瘤,但用于治疗典型类癌(typical carcinoid,TC)的研究并不普遍。本研究拟探讨支气管镜介入技术治疗典型类癌的近期疗效和远期疗效。方法回顾性分析北京应急总医院2010年12月-2020年12月可消瘤的腔内典型类癌患者的临床资料,采用Wilcoxon秩和检验和卡方检验进行统计分析。结果共纳入32例患者,术前支气管动脉栓塞18例(栓塞率56%,95%CI:31%-79%)。呼吸困难分级评分治疗后较治疗前下降,差异有统计学意义[(1.44±1.03)分vs(0.25±0.58)分,P=0.003];支气管管腔狭窄程度治疗后较治疗前改善,差异有统计学意义[(87.50%±13.90%)vs(17.50%±6.83%),P<0.001];支气管内径治疗后较治疗前扩宽,差异有统计学意义[(0.14±0.18)cm vs(0.84±0.29)cm,P<0.001]。近期有效率为100%。32例患者中24例支气管镜介入治疗能够完全消瘤,完全缓解(complete remission,CR)率为75%。结论支气管镜介入治疗技术治疗典型类癌的近期疗效及远期疗效显著。

Background and objective The curative potential of various bronchoscopic treatments such as electric snare,carbon dioxide freezing,argon plasma coagulation(APC),Neudymium-dopted Yttrium Aluminium Garnet(Nd:YAG)laser and photodynamic therapy(PDT)for the treatment of intraluminal tumor has been administered previously,but this regimen is not common in the treatment of typical carcinoid.The aim of this study is to investigate the curative effects both in short-term and long-term of interventional bronchoscopy in the treatment of typical carcinoid.Methods We retrospectively reviewed the clinical data of typical carcinoid patients who were treated with interventional bronchoscopy for tumor suppression and they were hospitalized in the Emergency General Hospital from December 2010 to December 2020,and Wilcoxon rank sum test and chi-square test were used for analysis.Results A total of 32 patients were included,including 18 cases of preoperative bronchial artery embolization(embolization rate 56%,95%CI:31%-79%).The grade score of dyspnea decreased from before treatment to after treatment,and the difference was statistically significant[(1.44±1.03)score vs(0.25±0.58)score,P=0.003];The degree of bronchial stenosis decreased from pre-treatment to post-treatment,and the diference was statistically significant[(87.50%±13.90%)vs(17.50%±6.83%),P<0.001];There was significant diference in bronchial diameter before and after treatment[(0.14±0.18)cm vs(0.84±0.29)cm,P<0.001].Conclusion Bronchoscopic interventional therapy has significant short-term and long-term effects in the treatment of typical carcinoid.