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目的 了解气管、支气管类癌的临床生物学特性 ,探讨合理的手术指征及术式。 方法对 2 0例气管、支气管类癌患者的外科治疗结果进行综合分析。 结果 气管、支气管类癌的临床特点和一般肺癌相比缺乏特征性表现 ,免疫组化结果提示其为神经内分泌细胞来源。 2 0例均予以手术切除 ,根治性切除率 95 0 % ,手术并发症发生率 10 0 %。术后病理报告典型类癌 13例 ,淋巴结转移率为 2 3 1% ;不典型类癌 7例 ,淋巴结转移率为 3/ 7。 13例典型类癌的 5 ,10 ,15年生存率分别为10 0 0 %、7/ 8及 3/ 4。 7例不典型类癌中 ,6例存活患者术后尚未满 5年 ,1例术后 2年余死于远处转移。 结论 手术切除是治疗类癌的主要手段。手术指征不应限于Ⅲa期及分期较早患者 ,对可能切净的Ⅲb期患者也应尽早手术。术式的选择应主要考虑患者的年龄及肺功能状况 ,对年轻、肺功能正常者 ,应以手术根治性为目的 ,否则应选择保守术式。
Objective To understand the clinical biological characteristics of tracheal and bronchial carcinoids and to explore reasonable surgical indications and surgical procedures. Methods A comprehensive analysis of the surgical treatment results of 20 patients with tracheal and bronchial carcinoids was conducted. Results The clinical features of tracheal and bronchial carcinoid tumors were lack of characteristic features compared with general lung cancer. The results of immunohistochemistry indicated that it was a source of neuroendocrine cells. Twenty patients underwent surgical resection, the radical resection rate was 95.0%, and the incidence of surgical complications was 10%. Postoperative pathology reported 13 cases of typical carcinoid, lymph node metastasis rate was 23%; atypical carcinoid in 7 cases, lymph node metastasis was 3/7. The 5, 10, and 15 year survival rates of 13 typical carcinoids were 100%, 7/8, and 3/4, respectively. Among 7 cases of atypical carcinoid, 6 cases of surviving patients were not 5 years after operation, and 1 case died of distant metastasis more than 2 years after surgery. Conclusion Surgical resection is the main method to treat carcinoid. Surgical indications should not be limited to patients with stage IIIa and earlier stages, and patients with stage IIIb who may be excision should also be operated as soon as possible. The choice of operation method should mainly consider the patient’s age and lung function status. For young people and normal lung function, the purpose of surgery should be radical, otherwise conservative surgery should be selected.