25例以心包积液为首发症状的非小细胞肺癌的临床诊治分析  

Diagnosis and treatment of 25 patients with pericardial effusion as the first manifestation of non-small cell lung cancer

作　　者：蒋桂成[1] 崔同建[1] 林贵山[1] 陈静波[1] 戴永美[1] JIANG Guicheng;CUI Tongjian;LIN Guishan;CHEN Jingb;DAI Yongmei(Department of Medical Oncology, Fujian Provincial Hospital, Provincial Medical College of Fujian Medical University, Fuzhou 350001, China)

机构地区：[1]福建医科大学省立临床医学院福建省立医院肿瘤内科,福州350001

出　　处：《临床肿瘤学杂志》2018年第11期1041-1044,共4页Chinese Clinical Oncology

摘　　要：目的探讨以心包积液为首发症状的非小细胞肺癌(NSCLC)的临床特征、诊断和治疗。方法回顾性分析2013年4月至2016年4月收治的25例以心包积液为首发症状的NSCLC患者的临床资料,总结分析临床病理特征、诊疗方法与治疗情况。结果以心包积液为首发症状的NSCLC患者的主要症状为气促、胸闷和干咳,从症状出现至确诊的中位时间为28天。全组患者均为中至大量心包积液,其中血性心包积液占76. 0%。淋巴结转移、脏器转移和胸腔积液的发生率分别为92. 0%(23/25)、80. 0%(20/25)和88. 0%(22/25)。单纯心包引流的有效率为71. 4%(5/7),全身化疗+心包引流的有效率为83. 3%(10/12),而表皮生长因子受体酪氨酸激酶抑制剂靶向治疗+心包引流的有效率为100. 0%(6/6),3种治疗方式RR的差异无统计学意义(P=0. 367)。结论以心包积液为首发症状的NSCLC的主要临床症状无特异性,应合理及时地引流心包积液缓解症状,提高生活质量,同时针对病因治疗。Objective To investigate the clinical features,diagnosis and treatment of non-small cell lung cancer(NSCLC)with pericardial effusion as the first manifestation.Methods The clinical records of25NSCLC patients with pericardial effusion as the first manifestation from April2013to April2016were retrospectively analyzed.The patients clinicopathological features,diagnosis and treatment methods and effects were summarized and analyzed.Results The main symptoms of NSCLC patients with pericardial effusion as the first manifestation were shortness of breath,chest congestion and dry cough.The median time from the onset of symptoms to diagnosis was28days.Twenty-five patients were with moderate-to-large pericardial effusion,and bloody pericardial effusion accounted for76.0%.The incidences of lymph node metastasis,organ metastasis and pleural effusion were92.0%(23/25),80.0%(20/25)and88.0%(22/25),respectively.The effective rates were71.4%(5/7),83.3%(10/12)and100.0%(6/6)for patients receiving simple pericardial drainage,systemic chemotherapy and pericardial drainage or epidermal growth factor receptor-tyrosine kinase inhibitor targeted therapy and pericardial drainage,respectively(P=0.367).Conclusion The main symptoms of NSCLC with pericardial effusion as the first manifestation had no specificity.Reasonable and timely drainage of pericardial effusion was needed to relieve symptoms and improve the quality of life.

关 键 词：非小细胞肺癌(NSCLC) 心包积液 肿瘤急症 化学治疗 靶向治疗 

分 类 号：R734.2[医药卫生—肿瘤]