原发性肺肉瘤的外科治疗  

Surgical Treatment of Primary Sarcoma of the Lung

作　　者：王永岗[1] 张汝刚[1] 张德超[1] 汪良骏[1] 张大为[1] 

机构地区：[1]中国医学科学院中国协和医科大学肿瘤医院胸外科,100021

出　　处：《实用癌症杂志》2003年第3期282-284,共3页The Practical Journal of Cancer

摘　　要：目的　了解原发性肺肉瘤的临床特点 ,探讨合理的外科治疗方法。方法　对 18例原发性肺肉瘤患者的临床资料进行回顾性分析。结果　术前仅 1例正确诊断 ,其余均误诊。手术切除率为 94.4% ( 17/18) ,手术并发症发生率及手术死亡率均为5 .6% ( 1/18)。术后病理检查结果 :恶性纤维组织细胞瘤 9例 ,纤维肉瘤 6例 ,神经纤维肉瘤 2例 ,脂肪肉瘤 1例。 4例中心型及 4例有淋巴结转移患者均为恶性纤维组织细胞瘤。患者 5年生存率为 38.5 % ( 5 /13) ,已证实死亡的 7例中 ,1例死于手术并发症 ,1例死于恶性胸腔积液 ,其余均死于血道转移。结论　原发性肺肉瘤术前易被误诊 ,手术切除是主要治疗手段 。Objective To understand the clinical characteristics of primary pulmonary sarcoma(PPS) and to find out rational surgical treatment.Methods The clinical materials of 18 surgically treated patients with PPS were retrospectively analyzed.Results A correct preoperative diagnosis obtained in only one patient.The resectibility,morbidity and 30-day mortality rates were 94.4%(17/18),5.6%(1/18) and 5.6%(1/18) respectively.Of the 18 patients,9 suffered from malignant fibrous histiocytoma,6 from fibrosarcoma,2 from neurofibrosarcoma and one from liposarcoma.Four cases with central tumor and 4 cases with lymph node metastasis all were patients suffered from malignant fibrous histiocytoma.The 5-year survival rate was 38.5%(5/13).Of the 7 deceased patients,one died of operative complication,one died of malignant pleural effusion,and others died of distant metastasis.Conclusion PPS can be easily misdiagnosed before operation.Surgical resection is the chief treatment.The operative indications and approaches should be depended on the patient′s situation.

关 键 词：原发性肺肉瘤 免疫组织化学检查 外科治疗 手术并发症 

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