原发性中叶肺癌的诊断与治疗  

Diagnosis and Surgical Treatment of Middle Lobe Carcinoma of the Lung

作　　者：赵一昕[1] 许栋生[1] 朱亚玲[1] 张家麒[1] 张伯生[1] 邹卫[1] 

机构地区：[1]南京胸科医院胸心外科

出　　处：《中华胸心血管外科杂志》1998年第1期21-23,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：中叶病变多因肺部感染所致，中叶肺癌发生率低而易误诊。为探讨中叶肺癌早期诊断和以手术为主综合治疗效果，总结１１年间手术治疗３９例中叶肺癌（占同期肺癌手术总例数的５．１％）。手术切除３４例（８７．１８％），开胸探查５例。手术方式以中叶切除和双肺叶切除为多。２３例术后辅以化疗或加免疫治疗。随访率为９２．３％。２３例术后化疗和免疫治疗者其１、３、５年生存率分别为８６．９５％、４３．４８％、３０．４３％。术后未作辅助治疗的１３例其１、３、５年生存率分别为６９．２３％、３０．７７％、１５．３８％。二组生存率相比有显著差异（Ｐ＜０．０５）。本组中晚期肺癌占多数，病理类型以腺癌居多。影响生存率的因素为病理分期、组织学和纵隔淋巴结转移。Aim:To review the experience of surgical management of middle lobe carcinoma of the lung.Clinical material and method:Between 1983 and 1994,39 patients with middle lobe carcinoma of the lung were treated surgically,accounting for 51% of the lung cancers treated at the same period.There were 26 men and 13 women with a mean age of 52.2 years.Resection was performed in 34 patients and exploration alone in 5 patients.By postresection staging,5 patients (12.88%) had stage I tumor,13 (33.33%) had stage II and 21 (53.84%) had stage III tumor.Surgical procedures included simple lobectomy in 58.82%,bilobectomy in 26.47%,right pneumonectomy in 11.76% and wedge resection in 2.94%. Postoperative chemotherapy or immunotherapy was carried out in 23 patients (combined therapy group). 92.3% of patients were followed up.Result:The resectability rate was 87.18%.There was no operative death.The postoperative morbidity rate was 7.7%.Overall one,three and fiveyear survival rates were 86.95%,43.48% and 30.43%,respectively.For surgical group,the 1,3 and 5year survival rates were 69.23%,30.77% and 15.38%,respectively.There was significant difference in longterm survival between combined therapy group and surgical group (P<0.05).Conclusion:Longterm survival rate is related to tumor staging,pathologic type of tumor and mediastinal lymph node metastases.The combined therapy after surgery may improve survival rate.

关 键 词：肺肿瘤 原发性 中叶病变 诊断 外科手术 

分 类 号：R734.2[医药卫生—肿瘤] R730.56[医药卫生—临床医学]