原发性肺部低度恶性肿瘤的临床特点与治疗概要.docVIP

?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 low2grade malignant carcinoma　HA N Ming,RUA N J unz hong,ZHI Xiuyi.Depart ment of Thoracic S urgery,Thoracic Tumors Hospital,Beijing101149,P.R.China 【Abstract】　Objective　To arrive at a rational diagnosis and effective surgical treatment of primary pulmonary low2grade malignant carcinoma.Methods　Eighty2nine patients with primary pulmonary low2grade malignant carci2 noma received surgical treatment from1956to2000.R esults　Out of the89patients,54were bronchial carcinoid, 18were mucoepidermoid cancer,and17were adenoid cystic carcinoma.The operative procedures included resection of tracheal carcinoma in3,lobectomy in49,sleeve lobectomy in14,total pneumonectomy in14,and wedge pneu2 monectomy in6.All patients were complaint free.The52year survival rates of bronchial carcinoid and adenoid cystic carcinoma were91.3%and70.6%res pectively,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 sites are main or lobe bronchi,and clinical symptoms are repeated infection of the lung or intermittent hemoptysis.The diagnosis depends on radiography or CT scan of chest and bronchofiberscopy.The operation is most important,and whose procedure is lobectomy or sleeve lobectomy mainly. 【K ey w ords】　Primary pulmonary low2grade malignant carcinoma　　Surgical treatment 　　原发性肺部低度恶性肿瘤包括类癌