中国肿瘤临床
中國腫瘤臨床
중국종류림상
CHINESE JOURNAL OF CLINICAL ONCOLOGY
2014年
11期
724-728
,共5页
钟文娟%邱峰%胡丽丽%尹燕军%张战民
鐘文娟%邱峰%鬍麗麗%尹燕軍%張戰民
종문연%구봉%호려려%윤연군%장전민
肺类癌%临床特征%病理%CT表现%预后
肺類癌%臨床特徵%病理%CT錶現%預後
폐유암%림상특정%병리%CT표현%예후
bronchopulmonary carcinoid%clinical features%pathology%CT%prognosis
目的：探讨原发性肺类癌的临床病理特征、CT表现、治疗方法及预后。方法：回顾性分析31例原发性肺类癌患者的诊治过程，并对预后行单因素和多因素分析。结果：临床表现：咳嗽、咳痰17例，咯血或痰中带血7例，胸痛、胸闷气短8例，无症状6例。CT表现：圆形或类圆形结节影，界限多清楚，增强可见轻度均匀强化。免疫组织化学检测提示：Syn、CgA、NSE阳性表达率分别为90.3%（28/31）、87.1%（27/31）、90.3%（28/31）。治疗及预后：28例行手术治疗（3例行术后辅助治疗）；2例行化疗，1例拒绝治疗。典型和不典型类癌的总体1年生存率分别为100%（18/18）、92.3%（12/13），3年生存率为94.4%（17/18）、69.2%（9/13）。单因素分析示淋巴结转移（P=0.02）、组织类型（P=0.017）、TNM分期（P=0.005）和治疗方法是影响预后的因素（P=0.01）。多因素分析示淋巴结转移（P=0.032）、组织类型（P=0.002）是影响预后的因素。结论：原发性肺类癌的临床及影像表现缺乏特异性，其诊断主要依靠组织病理。手术是其主要且有效的治疗途径，放化疗效果不佳；总体预后较好，但不典型类癌次于典型类癌，病理类型和淋巴结转移情况是影响预后的重要因素。
目的：探討原髮性肺類癌的臨床病理特徵、CT錶現、治療方法及預後。方法：迴顧性分析31例原髮性肺類癌患者的診治過程，併對預後行單因素和多因素分析。結果：臨床錶現：咳嗽、咳痰17例，咯血或痰中帶血7例，胸痛、胸悶氣短8例，無癥狀6例。CT錶現：圓形或類圓形結節影，界限多清楚，增彊可見輕度均勻彊化。免疫組織化學檢測提示：Syn、CgA、NSE暘性錶達率分彆為90.3%（28/31）、87.1%（27/31）、90.3%（28/31）。治療及預後：28例行手術治療（3例行術後輔助治療）；2例行化療，1例拒絕治療。典型和不典型類癌的總體1年生存率分彆為100%（18/18）、92.3%（12/13），3年生存率為94.4%（17/18）、69.2%（9/13）。單因素分析示淋巴結轉移（P=0.02）、組織類型（P=0.017）、TNM分期（P=0.005）和治療方法是影響預後的因素（P=0.01）。多因素分析示淋巴結轉移（P=0.032）、組織類型（P=0.002）是影響預後的因素。結論：原髮性肺類癌的臨床及影像錶現缺乏特異性，其診斷主要依靠組織病理。手術是其主要且有效的治療途徑，放化療效果不佳；總體預後較好，但不典型類癌次于典型類癌，病理類型和淋巴結轉移情況是影響預後的重要因素。
목적：탐토원발성폐유암적림상병리특정、CT표현、치료방법급예후。방법：회고성분석31례원발성폐유암환자적진치과정，병대예후행단인소화다인소분석。결과：림상표현：해수、해담17례，각혈혹담중대혈7례，흉통、흉민기단8례，무증상6례。CT표현：원형혹류원형결절영，계한다청초，증강가견경도균균강화。면역조직화학검측제시：Syn、CgA、NSE양성표체솔분별위90.3%（28/31）、87.1%（27/31）、90.3%（28/31）。치료급예후：28례행수술치료（3례행술후보조치료）；2례행화료，1례거절치료。전형화불전형유암적총체1년생존솔분별위100%（18/18）、92.3%（12/13），3년생존솔위94.4%（17/18）、69.2%（9/13）。단인소분석시림파결전이（P=0.02）、조직류형（P=0.017）、TNM분기（P=0.005）화치료방법시영향예후적인소（P=0.01）。다인소분석시림파결전이（P=0.032）、조직류형（P=0.002）시영향예후적인소。결론：원발성폐유암적림상급영상표현결핍특이성，기진단주요의고조직병리。수술시기주요차유효적치료도경，방화료효과불가；총체예후교호，단불전형유암차우전형유암，병리류형화림파결전이정황시영향예후적중요인소。
Objective:We aimed to explore the clinical features, computed tomography (CT) findings, treatment, and prognosis of bronchopulmonary carcinoid. Methods:Clinical data of 31 patients with primary carcinoid tumor of the lung were retrospectively re-viewed. The prognostic factors were analyzed via Cox univariate and multivariate analyses. Results: Clinical symptoms included coughing or expectoration in 17 of the 31 cases, hemoptysis or blood-stained sputum in 7 cases, and chest pains or shortness of breath in 8 cases. Six cases were asymptomatic. The CT scans showed round or oval nodules with clear boundaries, and enhancement CT scans indicated mild, homogeneous enhancement. Immunohistochemistry results revealed the positive expression rates of synaptophy-sin (Syn), chromogranin A (CgA), and neuron-specific enolase (NSE) were 90.3%(28/31), 87.1%(27/31), and 90.3%(28/31), respec-tively. Therapy and prognosis results were as follows:28 of the total number of patients underwent surgery, among which 3 underwent postoperative adjuvant therapy, 2 received chemotherapy; and only 1 refused treatment. The 1-year overall survival rates were 100%(18/18) and 92.3%(12/13), whereas the 3-year survival rates were 94.4%(17/18) and 69.2%(9/13) in the typical and atypical carcinoid cases, respectively. Cox univariate analysis results revealed that lymphatic metastasis (P=0.02), tissue types (P=0.017), TNM stage (P=0.005), and therapies (P=0.01) were the prognostic factors. Cox multivariate analysis results showed that lymphatic metastasis (P=0.032) and tissue types (P=0.002) were the independent prognostic factors. Conclusion:Compared with other lung cancers, the bron-chopulmonary lung carcinoid has no special clinical manifestation in clinical and radiographic images. The diagnosis was mainly based on histopathology results. Surgery was the main and effective treatment, whereas chemotherapy and radiotherapy showed unsatisfactory results. The overall prognosis was satisfactory. However, the atypical carcinoid was inferior to the typical carcinoid in terms of progno-sis. Pathological typing and lymph node metastasis were significant prognostic factors.
