中华胸心血管外科杂志
中華胸心血管外科雜誌
중화흉심혈관외과잡지
Chinese Journal of Thoracic and Cardiovascular Surgery
2012年
4期
233-236
,共4页
姚烽%周俊%仲晨曦%杨煜%赵珩
姚烽%週俊%仲晨晞%楊煜%趙珩
요봉%주준%중신희%양욱%조형
肺肿瘤%类癌瘤%胸外科手术%淋巴结%肿瘤转移%病理类型
肺腫瘤%類癌瘤%胸外科手術%淋巴結%腫瘤轉移%病理類型
폐종류%유암류%흉외과수술%림파결%종류전이%병리류형
Lung neoplasms%Carcinoid tumors%Thoracic surgical procedures%Lymph node%Neoplasm metastases%Pathological type
目的 总结肺类癌的外科治疗经验并分析影响预后的因素.方法 回顾性分析2000年1月至2010年10月收治的62例肺类癌临床资料,分别对性别、年龄、吸烟史、肿瘤家族史、组织类型、TNM分期等进行单及多因素预后分析.结果 全组无手术死亡.1例手术当日因血胸行再次剖胸止血；1例左下肺切除者术后2周发生支气管胸膜瘘急诊行支气管残端修补加网膜填塞术,术后2周痊愈出院；1例右上叶支气管袖状切除者术后0.5年吻合口瘢痕增生致右余肺不张行右余肺切除术.患者3年、5年生存率分别为92.1％、77.8％,好于其他类型肺癌.42例典型类癌患者中4例(8.3％)淋巴结转移,均为N1,术后3年生存率为97.8％,5年生存率为94.7％；20例不典型类癌中6例(37.5％)淋巴结转移,4例N1,2例N2,术后3年、5年生存率分别为84.4％、58.8％.典型类癌患者和不典型类癌患者3、5年生存率差异有统计学意义(P =0.0047),有、无淋巴结转移患者3、5年生存率差异有统计学意义(P =0.0048).多因素分析显示,影响预后的独立因素是病理类型(P =0.038)及有无淋巴结转移(P =0.023).结论 原发性肺类癌预后好于其他肺癌,确诊主要依靠术后病理诊断,根治性手术是主要治疗手段,对中央型肺类癌应首选袖状切除术.影响其预后的独立因素是病理类型(P =0.038)及有无淋巴结转移(P =0.023).
目的 總結肺類癌的外科治療經驗併分析影響預後的因素.方法 迴顧性分析2000年1月至2010年10月收治的62例肺類癌臨床資料,分彆對性彆、年齡、吸煙史、腫瘤傢族史、組織類型、TNM分期等進行單及多因素預後分析.結果 全組無手術死亡.1例手術噹日因血胸行再次剖胸止血；1例左下肺切除者術後2週髮生支氣管胸膜瘺急診行支氣管殘耑脩補加網膜填塞術,術後2週痊愈齣院；1例右上葉支氣管袖狀切除者術後0.5年吻閤口瘢痕增生緻右餘肺不張行右餘肺切除術.患者3年、5年生存率分彆為92.1％、77.8％,好于其他類型肺癌.42例典型類癌患者中4例(8.3％)淋巴結轉移,均為N1,術後3年生存率為97.8％,5年生存率為94.7％；20例不典型類癌中6例(37.5％)淋巴結轉移,4例N1,2例N2,術後3年、5年生存率分彆為84.4％、58.8％.典型類癌患者和不典型類癌患者3、5年生存率差異有統計學意義(P =0.0047),有、無淋巴結轉移患者3、5年生存率差異有統計學意義(P =0.0048).多因素分析顯示,影響預後的獨立因素是病理類型(P =0.038)及有無淋巴結轉移(P =0.023).結論 原髮性肺類癌預後好于其他肺癌,確診主要依靠術後病理診斷,根治性手術是主要治療手段,對中央型肺類癌應首選袖狀切除術.影響其預後的獨立因素是病理類型(P =0.038)及有無淋巴結轉移(P =0.023).
목적 총결폐유암적외과치료경험병분석영향예후적인소.방법 회고성분석2000년1월지2010년10월수치적62례폐유암림상자료,분별대성별、년령、흡연사、종류가족사、조직류형、TNM분기등진행단급다인소예후분석.결과 전조무수술사망.1례수술당일인혈흉행재차부흉지혈；1례좌하폐절제자술후2주발생지기관흉막루급진행지기관잔단수보가망막전새술,술후2주전유출원；1례우상협지기관수상절제자술후0.5년문합구반흔증생치우여폐불장행우여폐절제술.환자3년、5년생존솔분별위92.1％、77.8％,호우기타류형폐암.42례전형유암환자중4례(8.3％)림파결전이,균위N1,술후3년생존솔위97.8％,5년생존솔위94.7％；20례불전형유암중6례(37.5％)림파결전이,4례N1,2례N2,술후3년、5년생존솔분별위84.4％、58.8％.전형유암환자화불전형유암환자3、5년생존솔차이유통계학의의(P =0.0047),유、무림파결전이환자3、5년생존솔차이유통계학의의(P =0.0048).다인소분석현시,영향예후적독립인소시병리류형(P =0.038)급유무림파결전이(P =0.023).결론 원발성폐유암예후호우기타폐암,학진주요의고술후병리진단,근치성수술시주요치료수단,대중앙형폐유암응수선수상절제술.영향기예후적독립인소시병리류형(P =0.038)급유무림파결전이(P =0.023).
Objective To evaluate prognostic factors and the surgical results of pulmonary carcinoid tumors.Methods We retrospectively reviewed the medical records of 62 patients who were diagnosed as pulmonary carcinoid tumors between January 2000 and October 2010 at Department of Thoracic Surgery,Shanghai Chest Hospital.The following information was available for each of the 62 patients:age,sex,pathological type,and TNM stage.Results There were no operative death.The 3-year and 5-year survival rates after surgery were 92.1％ and 77.8％,respectively.Of the 62 patients,42 were diagnosed as typical carcinoid tumor,and among them,4 patients (8.3％) had lymph node metastases.Their 3-year and 5-year survival rates were 97.8％ and 94.7％,respectively.The remaining 20 patients were diagnosed as atypical carcinoid tumor,and among them,6 patients (37.5％) had lymph node metastases.Their 3-year and 5-year survival rates were 84.4％ and 58.8％,which were statistically significant compared with typical carcinoid tumor( P =0.0047 ).There was significant difference in survival rate between the patients with lymph node metastases and the patients without lymph node metastases (P =0.0048).Condusion The main risk factors affecting survival rate of those patients who were diagnosed as pulmonary carcinoid tumors were pathological types and lymph node metastases.
