气管支气管类癌20例

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20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、支气管炎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。20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23．1％，；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100．0％、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，对年龄、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。

Carcinoid of trachea and bronchus: a report of 20 cases

OBJECTIVE: To understand the biologic and clinical characteristics of carcinoid tumor of trachea and bronchus and to find out rational surgical indications and approaches. METHODS: The clinical materials of 20 surgically treated patients with carcinoid of trachea and bronchus were retrospectively analyzed. RESULTS: All but one patient received radical tumor resection. Operative complication occurred in 2 patients. Of the 20 patients, 13 suffered from typical carcinoids (TC) and 7 from atypical carcinoids (AC). Immunochemical staining revealed that both the typical and atypical carcinoids were of neuroendocrine origin. The 5-, 10- and 15-year survival rate of TC patients was 100.0%, 7/8 and 3/4 respectively. Of the 7 patients with AC, 6 had not yet been 5 years after operation but were still alive, and one patient died of remote metastasis 2 years after operation. CONCLUSION: Surgical resection of carcinoid is indicated not only for early cases, but also for patients in stage III a and III b. The age and pulmonary function of the patients are the chief factors determining the surgical approach.