原发性气管及主支气管恶性肿瘤的临床诊治

目的:探讨原发性气管、主支气管恶性肿瘤的临床诊治特点,以期提高其临床诊治水平。方法:回顾性分析复旦大学附属中山医院胸外科2005年1月至2015年12月手术治疗的35例原发性气管、主支气管恶性肿瘤患者的临床资料,分析疾病特点,总结临床经验。结果:35例患者临床症状表现为咳嗽、咳痰、痰血、咳血、气急、胸闷、胸痛、发热等。13例(37.1%)患者早期误诊。所有患者均经手术治疗,术后均无并发症发生,3例行术后放疗。术后31例完成随访的患者中,26例存活,5例死亡,无瘤生存时间平均为(34±16.2)个月(16~49个月),中位生存时间50个月(16~138个月)。结论:原发性气管、支气管恶性肿瘤临床表现无特异性,易误诊,应及早行气管镜和胸部CT检查;确诊后积极手术治疗可取得良好的预后。

Clinical analysis of 35 cases with primary malignant tumors of the trachea and main bronchus

To investigate the clinical features, diagnosis and surgical treatment of primary malignant tumors of the trachea and main bronchus. Methods: Clinical data of 35 cases with primary malignant tumors of the trachea and main bronchus in Zhongshan Hospital, Fudan University between January 2005 and December 2015 was analyzed retrospectively. Result: The clinical symptoms were cough, sputum, bloody sputum, hemoptysis, shortness of breath, chest tightness, thoracalgia, and fever. There were 13 cases (37.1%) proved to be misdiagnosed in the early stage. All patients were eventually diagnosed by chest CT or bronchoscopy and pathological examination including mucoepidermoid carcinomas (11 cases), squamous cell carcinomas (10 cases), adenoid cystic carcinomas (8 cases), , malignant peripheral nerve sheath tumors (3 cases), lymphoepithelial carcinoma (1 case), carcinoid (1 case) and acinar cell carcinoma (1 case). Among the 31 cases received postoperative follow-up, 26 cases survived, 5 cases died. The average disease-free interval was 34 months (16 to 49 months) and the median survival time was 50 months (16-138 months). Conclusion: primary malignant tumors of the trachea and main bronchus without special clinical manifestations are easy to be misdiagnosed so that early bronchoscopy and chest CT examination are necessary. Active surgery treatment for primary malignant tumors of the trachea and main bronchus do generate good prognosis.