原发性中叶肺癌的诊断和外科治疗  

Diagnosis and Surgical Treatment of Middle Lobe Lung Cancer

作　　者：王彪[1,2] 于在诚[1] 唐震[2] 刘学刚[2] 王祖义[2] 段贵新[2] 李小军[2] 

机构地区：[1]安徽医科大学第一附属医院胸外科 [2]安徽省蚌埠医学院第一附属医院胸外科,233004

出　　处：《中华全科医学》2011年第3期354-355,共2页Chinese Journal of General Practice

摘　　要：目的探讨原发性中叶肺癌的临床诊断和外科治疗。方法回顾性分析2003～2007年外科治疗的36例中叶肺癌的临床资料及手术方法。结果行根治性肺叶切除手术34例,其中中叶切除10例,双肺叶切除20例,右全肺切除4例,剖胸探查2例,清扫N1淋巴结108组,N2淋巴结133组,N1阳性5例,N2阳性1例,N1+N2阳性7例,Ⅰ期5例,Ⅱ期11例,ⅢA期15例,ⅢB期2例,Ⅳ期1例。病理类型以腺癌居多,术后20例行化疗。手术无死亡病例,1年、3年、5年生存率分别为83.3%、52.7%、38.8%。结论中叶肺癌发病率较低,易误诊和延误诊断,需与中叶肺良性病变相鉴别,治疗以根治性肺叶切除为主,由于解剖特点,需行中上叶或中下叶切除,清扫上下纵膈淋巴结是手术根治的关键。Objective To study the characteristics of diagnosis and surgical treatment of middle lobe carcinoma of the lung. Methods The clinical data and therapeutic results of 36 patients with middle lobe lung cancer from 2003 to 2007 in our hospital who had undergone surgical treatment were retrospectively studied. Results Thirty-four radical resections were taken, in which 10 lobetomies,20 bilobectomies,4 pneumonectomies and 2 exploratory thoracotomy. Altogether 108 N1 and 133 N2 lymph nodes were cleared up. Based on pathologic results, positive lymph nodes of N1 were identified in 5 cases, N2 in 1 case, and both Nl and N2 in 7 cases. There were stage I 5 cases, stage ]I 11 cases,stage IliA 15cases,stage ms 2 cases,stage IV 1 case. Most of the patients were characterized by adenocarcinoma,20 cases were treated with chemotherapy after operation, no death occurred, one year,three years and five years survival rate of patients was 83.3% ,72.73% and 38.8% respectively. Conclusion The inci- dence of the middle lobe lung cancer was lower,it was often misdiagnosed and mistreated. It should be distinguished with benign disease of middle lobe lung. Therapy should be focused on radical pulmonary lobe excision. Since the dissection characteristics ,above-average leaf or below-average leaf resection, cleaning mediastinal lymph node was the key of radical resection.

关 键 词：中叶肺癌 肺肿瘤/诊断 外科治疗 纵膈淋巴结清除 

分 类 号：R734.2[医药卫生—肿瘤]