赵晓亮, 张 强, 苏延军, 王长利. 27例原发性肺类癌的临床特点和预后分析[J]. 中国肿瘤临床, 2010, 37(18): 1057-1059. DOI: 10.3969/j.issn.1000-8179.2010.18.011
引用本文: 赵晓亮, 张 强, 苏延军, 王长利. 27例原发性肺类癌的临床特点和预后分析[J]. 中国肿瘤临床, 2010, 37(18): 1057-1059. DOI: 10.3969/j.issn.1000-8179.2010.18.011
ZHAO Xiaoliang, ZHANG Qiang, SU Yanjun, WANG Changli. Clinical Characteristics and Prognostic Analysis of  27 Cases of Bronchopulmonary Carcinoid[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2010, 37(18): 1057-1059. DOI: 10.3969/j.issn.1000-8179.2010.18.011
Citation: ZHAO Xiaoliang, ZHANG Qiang, SU Yanjun, WANG Changli. Clinical Characteristics and Prognostic Analysis of  27 Cases of Bronchopulmonary Carcinoid[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2010, 37(18): 1057-1059. DOI: 10.3969/j.issn.1000-8179.2010.18.011

27例原发性肺类癌的临床特点和预后分析

Clinical Characteristics and Prognostic Analysis of  27 Cases of Bronchopulmonary Carcinoid

  • 摘要: 目的:研究分析肺类癌的临床治疗特点以及预后影响因素。方法:选取天津医科大学附属肿瘤医院1974年1 月至2005年8 月病例资料完整的肺类癌27例,进行回顾性研究。结果:典型类癌15例,不典型类癌12例;无吸烟史12例,有吸烟史15例,其中吸烟指数<400 的2 例,≥400 者13例。临床表现以咳嗽、痰中带血为主;肺类癌的影像学特征与病理学分类无相关性(χ2=2.87,P=0.091),纤支镜活检22例,有明确病理诊断1 例;共24例接受手术治疗,手术分为根治性手术和保守性手术。21例接受根治性手术,其中3 例行全肺切除,18例单纯肺叶切除;保守性袖状切除术3 例。接受术后辅助性化疗或单纯化疗的患者,方案以顺铂或卡铂为主的二联或三联药物。1、3、5 年生存率分别为96.2% 、90.4% 和64.6% 。与肺类癌预后相关的主要因素为临床分期(χ2=4.26,P=0.04)和淋巴结转移情况(χ2=4.22,P=0.040)。 结论:肺类癌的临床表现、影像学缺乏特异性改变,纤支镜活检病理诊断阳性率低。肺类癌的预后较好,预后与临床分期和淋巴结转移相关。术后辅助性化疗在整个治疗过程中的地位还有待于进一步研究。

     

    Abstract: Objective:To study the clinical and biological characteristics, treatment, and prognosis of bronchopulmona -ry carcinoid (BPC). Methods:A total of 27patients with lung carcinoid tumors, treated at Tianjin Medical University Cancer Hospital from January 1974 to August 2005 and having complete clinical data, were retrospectively reviewed. Results: Of the 27cases: 15patients were confirmed pathologically as having typical carcinoid and 12with atypical carcinoid;12pa-tients had no smoking history and 15cases had smoking history ( 2 had a smoking index level of less than400 and 13had greater or equal to 400 ); 22cases were examined with a fiberbronchoscope before the operation, but only 1 case had a positive result. The clinical manifestation of the lung carcinoid is a cough, the radiographic characteristics had no relation-ship with the pathological types ( χ2=2.87,P=0.091 ). Twenty-four cases received surgery, 21radical ( 3 were routine pneumo-nectomy, 18were lobectomy) and3 conservative sleeve resection. Patients received postoperative adjuvant chemotherapy or chemotherapy alone with programs of cisplatin or carboplatin-based 2 drugs together or on a triple drugs chemotherapy plan. All the chemotherapy was continued for 1 ~ 6 cycles. Survival rates for1-, 3-, and 5-years were 96.2%,90.4% and 64.6%, respectively. The lymph nodes metastasis (χ2=4.22, P=0.04) and clinical stage (χ2=4.26, P=0.04) were the signifi -cant prognostic factors. Conclusion : Long term survival can be obtained. Compared with lung cancer and other lung benign tumors, the bronchopulmonary carcinoid has no special manifestation as the clinical and radiographic characteristics. The positive pathological diagnosis from fiberbronchoscope is low. Lymph node metastasis and stage are the significant prog-nostic factors. The status of postoperative adjuvant chemotherapy in the whole course of treatment remains to be further studied.

     

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