原发性肺部低度恶性肿瘤的临床特点与治疗.pdfVIP

中国肺癌杂志2002 年 8 月第 5 卷第 4 期　Chin J Lung Cancer , August 2002 ,Vol. 5 , No. 4 2·87 · ·临床研究· 原发性肺部低度恶性肿瘤的临床特点与治疗 韩鸣 　阮军忠 　支修益 【摘要】　目的　探讨原发性肺部低度恶性肿瘤的临床特点和外科手术治疗的术式选择。方法 　总结并 分析了我院胸外科自 1956 年 2000 年间手术治疗 89 例原发性肺部低度恶性肿瘤的临床资料。结果 　本组 89 例中 ,支气管类癌 54 例 ,粘液表皮样癌 18 例 ,腺样囊性癌 17 例。行气管内肿物单纯切除 3 例 ,肺叶切除 49 例 ,支气管袖式肺叶切除 14 例 ,全肺切除 14 例 ,肺楔形切除 6 例。全组无手术死亡。随访资料统计显示支气 管类癌的 5 年生存率为 91. 3 % ,腺样囊性癌的 5 年生存率为 70. 6 % ,粘液表皮样癌的 5 年生存率为 100 % ,未 出现复发及转移。结论 　支气管类癌、粘液表皮样癌、腺样囊性癌是一组低度恶性的肺部肿瘤 ,主要好发于主 支气管和叶支气管 ,临床症状多表现为肺部反复感染和间断血痰。胸部影像学和纤维支气管镜检查多能获得 明确诊断。其治疗手段主要是外科手术 ,切除范围取决肿瘤的部位和受阻塞的肺组织的情况 ,常规肺叶切除 和支气管袖式肺叶切除是主要的外科手术式。 【关键词】　原发性肺部低度恶性肿瘤 　　外科治疗 【中图分类号】　R734. 2 Surgical treatment of primary pulmonary lowgrade malignant carcinoma 　HA N Ming , RUA N J unz hong , ZHI Xiuyi . Depart ment of Thoracic S urgery , Thoracic Tumors Hospital , Beijin g 101149, P. R . China 【Abstract 】　Objective 　To arrive at a rational diagnosis and effective surgical treatment of primary pulmonary lowgrade malignant carcinoma. Methods 　Eightynine patients with primary pulmonary lowgrade malignant carci noma received surgical treatment from 1956 to 2000. Results 　Out of the 89 patients , 54 were bronchial carcinoid , 18 were mucoepidermoid cancer , and 17 were adenoid cystic carcinoma. The operative procedures included resection of tracheal carcinoma in 3 , lobectomy in 49 , sleeve lobectomy in 14 , total pneumonectomy in 14 , and wedge pneu monectomy in 6. All patients were complaint free. The 5year survival rates of bronchial carcinoid and adenoid cystic carcinoma were 91. 3 % and 70. 6 % respectively , and no patients with bronchial mucoepidermoid cancer died until now. Conclusion 　Bronchial carcinoid , adenoid cystic carcinoma and mucoepidermoid cancer are a series of primary pulmonary carcinoma of low malignant potential , whose predilection