电视胸腔镜活检在诊断和治疗纵隔恶性淋巴瘤中的意义  

Importance of video-assisted thoracoscopic biopsy in diagnosis and treatment of mediastinal lymphoma

作　　者：滕洪[1] 徐惟[1] 王述民[1] 曲家骐[1] 

机构地区：[1]解放军沈阳军区总医院胸外科,辽宁沈阳110016

出　　处：《临床军医杂志》2013年第11期1133-1134,共2页Clinical Journal of Medical Officers

摘　　要：目的探讨经电视胸腔镜活检（VATMLB）在纵隔恶性淋巴瘤诊断和治疗中的意义。方法自2007年6月-2011年10月经电视胸腔镜行前纵隔淋巴瘤活检14例，并进行病理组织学和免疫组织化学检测，明确诊断，并根据病理分型（WHO分型）采用相应化疗方案或（和）联合放疗方案治疗，并对治疗效果进行随访。结果14例均活检成功，无手术并发症，病理结果：霍奇金淋巴瘤8例，大B细胞淋巴瘤5例，外周T细胞淋巴瘤1例。根据其病理分型给予相应方案化疗或化疗联合放疗，随访3～55个月，完全缓解（CR）4例（28．6％），部分缓解（PR）8例（57．1％），稳定（sD）1例（7．1％），进展恶化（PD）1例（7．1％）。总有效率：85．7％。1年生存率为100％（10、10），2年生存率100％（6／6），3年生存率66．7％（2／3）。结论电视胸腔镜纵隔活检能够取得足够肿瘤组织进行病理组织学和免疫组织化学检查准确诊断纵隔淋巴瘤并对纵隔淋巴瘤分型，对于指导纵隔淋巴瘤诊断、治疗和预后的判断具有重要的意义，具有准确、安全、微创等优点。Objective To evaluate the importance of video-assisted thoracoscopic biopsy in the diagnosis and treatment of mediastinal lymphoma. Methods From June 2007 to October 2011, thoracoscopic biopsy was performed in 14 patients with mediastinal tumor. All the patients got confirmed diagnosis of lymphoma by immunohistochemical examination. According to the pathological type （WHO classification） , the patients received relevant targeted chemotherapy or radio-chemotherapy and follow-up. The data were collected and analyzed. Results All the 14 cases got exact biopsy by video-assisted thoracoscopic approach without complications. The pathological findings were as follow： Hodgkin lymphoma in 8, large b-cell lymphoma in 5 and peripheral T-cell lymphoma in 1 case （ s ）. After targeted chemotherapy and radio-chemotherapy for different pathological type and follow-up of 3 - 55 months, complete remission （CR） was reached in 4 （28.6%）, partial remission （PR） in 8 （57.1%）, stable disease （SDi in 1 （7.1% ） and progressive disease （PD） in 1 （7.1% ） case（s）. The remission rate reached 85.7%. The survival rate for 1 year was 100% （10/10） , 2 years 100% （6/6） and 3 years 66.7% （2/3）. Conclusion Thoracoscopic mediastinal tumor biopsy is an accurate, safe and effective method to the diagnosis of mediastinal lymphoma. Immunohistochemistry examination contributes to confirm the histological origin and pathological type, which provide definitive evidence for further treatment.

关 键 词：纵隔淋巴瘤 电视胸腔镜活检 

分 类 号：R733.4[医药卫生—肿瘤]