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目的探讨联合经皮及经气管镜引导腔内冷冻消融治疗中央型肺癌的疗效。方法 47例不可切除的中央型肺癌患者(22个气管内型病灶,26个气管壁型病灶,21个气管外型病灶)共行69次经皮、经气管镜引导腔内冷冻消融治疗,统计无进展生存期(PFS),分析冷冻治疗后的PFS与肿瘤生长部位、病理类型及分化程度关系。结果气管内型肿瘤PFS(8±4个月)明显低于气管壁型肿瘤(13±6个月)(P<0.05)及气管外型肿瘤(14±8个月)(P<0.01);非小细胞肺癌PFS(11±5个月)明显长于小细胞肺癌(4±2个月)(P<0.0001);高、中分化癌PFS(15±8个月)明显长于低分化癌(7±3个月)(P<0.0001)。结论联合经皮及经气管镜引导腔内冷冻消融治疗是中央型肺癌的一种有效、安全治疗方法,其术后PFS与肿瘤生长部位、病理类型及分化程度相关。
Objective To investigate the curative effect of combined percutaneous and endoscopic cryoablation in the treatment of central lung cancer. Methods Forty-seven patients with unresectable central lung cancer (22 intratracheal endotracheal lesions, 26 tracheal wall lesions and 21 tracheal lesions) were treated with 69 percutaneous transluminal cryosurgery guided by endoscope. Progression-free survival (PFS), analysis of PFS after cryotherapy and tumor growth sites, pathological types and the degree of differentiation. Results PFS (8 ± 4 months) in endotracheal tumors was significantly lower than that in tracheal wall tumors (13 ± 6 months) (P <0.05) and tracheal tumors (14 ± 8 months) (P <0.01). The PFS of non-small cell lung cancer (11 ± 5 months) was significantly longer than that of small cell lung cancer (4 ± 2 months) (P <0.0001) ± 3 months) (P <0.0001). Conclusion Combined percutaneous and endoscopic cryoablation is an effective and safe method for the treatment of central lung cancer. The postoperative PFS correlates with tumor growth, pathological type and degree of differentiation.