周边型小肺癌的几个临床问题  

Several clinical issues of peripheral small lung cancer

作　　者：孟凡利[1] 宋晓明[1] 臧琦[1] 王伟[1] 赵强[1] 朱强[1] 

机构地区：[1]山东省千佛山医院胸外科,山东济南250014

出　　处：《肿瘤防治杂志》2004年第7期730-731,741,共3页China Journal of Cancer Prevention and Treatment

摘　　要：我科共手术治疗原发性肺癌 5 87例 ,包括周围型小肺癌 49例 ,其中腺癌 2 9例 ,鳞癌 9例 ,腺鳞癌 3例 ,大细胞癌 2例 ,未分化小细胞癌 6例。pTNM分期 ,Ⅰ期 (T1N0 M0 ) 3 2例 ,Ⅱ期 (T1N1M0 ) 9例 ,ⅢA期 (T1N2 M0 ) 8例。共实行 5 2术次 ,( 3例I期腺癌术后复发二次手术 )。结果鳞癌的 5年生存率优于腺癌和其他组织类型肺癌 ;同组织类型小肺癌比较 ,N0 优于N1,N1优于N2 。既便是早期小肺癌 ,尤其是腺癌 ,预后也不全令人乐观。初步研究结果提示 ,小肺癌并不全是早期肺癌 ,术后的综合治疗仍是不可缺少的。All 587 patients with primary lung cancer underwent surgical treatment (pulmonary resection)in Qianfoshan hospital.There were 49 patients with peripheral small lung cancer. Tumor cell types were:squamous carcinoma, 9 cases; adenocarcinoma,29 cases;adenosquamous carcinoma,3 cases;large cell carcinoma,2 cases and undifferentiated small cell carcinoma, 6 cases. Pathologic stage according to the TNM classification of UICC (1984) on lung cancer was as follows: Stage Ⅰ(T 1N 0M 0),32 cases;Stage Ⅱ(T 1N 1M 0),9 cases and Stage ⅢA(T 1N 2M 0),8 cases.All 49 patients with peripheral small lung cancer received surgical treatment.Without obvious symptoms and signs, most patients with periphral small lung cancer were easily overlooked.Regular check-up for the high risk group contributed to the early detection of piripheral small lung cancer.CT-guided percutaneous transthoracic needle biopsy of an indeterminate peripheral lung tumor was often helpful in confirming the diagnosis.The selection of operation on peripheral small lung cancer was based on pathologic cell type as well as lymph nodes involvement. Limited resection of tumor should only be performed on the following indication:peripherally located squamous cell carcinoma,senile and weak patient,cardiopulmonary dysfunction.Although operation is the appropriate mangement for small lung cancer ,it should be pointed that postoperative multimodel treatment was still indispensable.

关 键 词：肺肿瘤/外科学 存活率 预后 

分 类 号：R734.2[医药卫生—肿瘤]