肺类癌12例临床分析  

Lung carcinoids: a retrospective study on clinical features, diagnosis and treatment

作　　者：郝明文[1] 张伟[1] 王晓洁[1] 张宏伟[1] 刘艳华[1] 

机构地区：[1]烟台毓璜顶医院胸外科,山东烟台264000

出　　处：《肿瘤防治杂志》2005年第23期1819-1820,共2页China Journal of Cancer Prevention and Treatment

摘　　要：为了探讨肺类癌的临床特点、诊疗方法与预后的影响因素,对12例肺类癌病例进行回顾性研究。12例患者中2例伴有类癌综合征,2例术前经纤支镜确诊。术式包括肺叶切除9例,开胸探查1例,全肺切除2例,无手术期死亡和并发症。全组5年生存率为72.65%,类癌5年生存率为84.23%,不典型类癌为66.68%。初步研究结果提示,肺类癌属低度恶性肿瘤;影像学及纤维支气管镜检查对诊断具有重要价值;光镜HE染色常可诊断,但嗜银染色及电镜确定特征性嗜银性神经内分泌颗粒是确诊的可靠标准;治疗应以保守性外科手术切除为主,尽量保留肺功能为手术原则;手术切除后预后良好,远期疗效明显优于肺癌。The purpose of this study was to investigate the clinical behavior of lung carcinoids and clarify a surgical approach. Twelve patients operated for lung careinoids were retrospectively reviewed for clinicopathologic variables, surgical management, and outcome. Tumors were considered as ＂typical＂ or ＂atypical＂ according to histologic features. Survival analysis was performed by using the standard statistical methods. All patients presented with an abnormal routine chest X-ray. Two patients had the carcinoid syndrome. Computed tomography scan reliably predicted lymph nodes status and bronehoscopic biopsy diagnosed carcinoids with 16.67% success. Lobectomy, pneumonectomy and thoracotomy were performed. Six patients had atypical carcinoids, the others had typical carcinoids. Overall stirvival rate was 72.65% at 5 years. Lung carcinoids have a good prognosis and a definite malignant potential predic ted by atypical histology, presence of tumorlets, and lymph node involvement. These features can be identified with routine bronchoscopic biopsy, computed tomography scanning, and intraoperative assessment including frozen sec tion. In the selected group of patients without negative features, strong consideration should be given to perform a conservative resection,

关 键 词：肺肿瘤/诊断 肺肿瘤/治疗 类癌瘤 

分 类 号：R734.2[医药卫生—肿瘤]