气管、支气管成型术在Ⅲ期非小细胞肺癌治疗中的作用

本文回顾性分析我所胸外科1980～1990年间52例气管、支气管成型术在Ⅲ期非小细胞肺癌的治疗作用。全组男性44例，女性8例，平均年龄55岁，52例患者均为中心型癌：鳞癌42例、腺癌6例，鳞腺癌3例，类癌1例，其中Ⅲa期45例，Ⅲb期7例。结果显示：52例患者中3、5、10年生存率分别为25％、21％、8．8％。其中3年以上生存者中除1例类癌外，全部为鳞癌。全组N230例，仅3例存治超过3、5年。本组残端阳性发生率占38％，在残端阳性病例中，伴淋巴转移者无1例长期生存。结论认为：在Ⅲ期非小细胞肺癌中，气管、支气管成形术宜在鳞癌、类癌及非N2病例中严格、慎重的选择性应用。术中残端冰冻检查对成型的效果有相关作用。

The Role of Tracheobronchoplasty on the Treatment of Stage Ⅲ Non-Small Cell Lung Carcer (NSCLC)

52 cases of the tracheobronchoplasty on the patients with stage ⅢNSCLC in our thoracic surgery depattment during the period form 1980~1990 were revieweds. Of the 52 patients, 44 were male and 8 were female, mean age was 55yrs.All petients were indicated for central tumours,42 patients with squamous cell carcinoma, 6 with adenocarcinoma,3 with adeno-sequamous, 1 with carinoid. There were 45 patients in stage Ⅲa, 7 in stage Ⅲb. Tha results revealed that survival rate at 3,5, and 10 yrs is 25%, 21 % and 8% respectively. All of the petients who survived im than 3 yrs were with squamous, but 1 with carinoid trmour. and only 3 survived more than 3 yrs among the 30 patients with N2. In the series, the resection margin positive account for 38% in which,no one with N1or N2 Status who survied for long - term. Conclusion: the use of tracheobronchoplasty on stage Ⅲ NSCLC should be confined prudentially and striclty in a selected group of patients with squamous and carcinoid tu mour, especially in non N2 patients. The margin frozen is related to the effect of trachforchoplasty.