肺类癌的外科治疗及预后分析

张 ZHANG)

薛 XUE)

温 WEN)

Bo Wang

初 CHU)

背景与目的

肺类癌是一种少见的神经内分泌肿瘤，有关其预后因素的研究较少。本研究旨在探讨外科手术治疗肺类癌的疗效，并分析其预后影响因素。

方法

回顾2000年1月-2017年12月解放军总医院收治的肺类癌患者的临床资料。以Kaplan-Meier方法计算患者的生存率，比较不同因素对预后的影响，进行单因素分析，并采用Log-rank检验; 通过Cox比例风险模型进行多因素分析。

结果

98例肺类癌患者行外科手术治疗，其中典型类癌和不典型类癌者分别41例、57例。肺类癌患者的5年及10年总体生存率分别为80.0%、73.6%。单因素分析显示，年龄(P=0.000, 1)、吸烟(P=0.005)、病理亚型(P < 0.000, 1)、肿瘤分期(P < 0.000, 1)、T分期(P=0.000, 2)是影响预后的因素。多因素分析显示，年龄(P=0.005)、肿瘤分期(P=0.017)是预后的独立影响因素。

结论

行外科手术治疗的肺类癌患者总体预后较好。年龄、肿瘤分期是影响肺类癌术后远期生存的独立危险因素。

Background and objective

Bronchopulmonary carcinoid (BPC) is a rare neuroendocrine tumor, the clinical studies on treatment and prognostic factors of BPC are somewhat controversial. Our purpose was to evaluate the clinical efficacy of surgery on BPC, and to analyze the prognostic factors affecting the survival of BPC.

Methods

We retrospectively collected the clinical data of patients with BPC admitted to the Chinese PLA General Hospital between January 2000 and December 2017. The Kaplan-Meier method was used to calculate the survival rate of patients and to map the survival curve. Then the effects of different factors like pathological classification, gender, age, on prognosis were compared by univariate analysis and multivariate analysis was made by Cox proportional hazard model.

Results

A total of 98 patients had a diagnosis of BPC were included in the study. There were 41 patients with typical carcinoid (TC) and 57 patients with atypical carcinoid (AC). The 1-yr, 5-yr, and 10-yr overall survival rates of BPC were 96.9%, 80.0% and 73.6%, respectively. Univariate analysis showed age (P=0.000, 1), smoking history (P=0.005), pathological subtype (P < 0.000, 1), T stage (P=0.000, 2), TNM stage (P < 0.000, 1) were the prognostic factors. Multivariate analysis showed that age (P=0.005) and tumor stage (P=0.017) were independent prognostic factors.

Conclusion

BPC occurred more in middle-aged men. Surgery is the main treatment for lung cancer, and the overall prognosis is good. Age and TNM stage were independent risk factors for long-term survival after lung cancer surgery.

^{100853 北京，中国人民解放军总医院胸外科一病区, Department of Thoracic Surgery, PLA General Hospital, Beijing 100853, China,}

薛志强 (Zhiqiang XUE): moc.621@103gnaiqihzeux

薛志强, Zhiqiang XUE, E-mail: moc.621@103gnaiqihzeux

薛志强 (Zhiqiang XUE): moc.621@103gnaiqihzeux

Received 2019 Mar 21; Revised 2019 May 12; Accepted 2019 Jun 5.

Abstract

背景与目的

肺类癌是一种少见的神经内分泌肿瘤，有关其预后因素的研究较少。本研究旨在探讨外科手术治疗肺类癌的疗效，并分析其预后影响因素。

方法

结果

结论

行外科手术治疗的肺类癌患者总体预后较好。年龄、肿瘤分期是影响肺类癌术后远期生存的独立危险因素。

Keywords: 肺肿瘤, 类癌, 手术, 预后

Abstract

Background and objective

Methods

Results

Conclusion

Keywords: Lung neoplasms, Carcinoid tumor, Surgery, Prognosis

Abstract

肺类癌起源于支气管黏膜下Kulchitsky细胞，是一种分化良好的神经内分泌肿瘤，占全身所有类癌的1/4-1/3，分为典型类癌(typical carcinoid, TC)和不典型类癌(atypical carcinoid, AC)¹, 2]。有研究¹, 3]表明肺类癌发病率呈持续上升趋势，外科手术是唯一能够治愈局限期肺类癌的手段。但是关于肺类癌的生存率及影响肺类癌术后远期生存因素的研究较少，且不同研究之间有一定争议³-6];本研究旨在探讨外科手术治疗肺类癌的疗效，并分析影响肺类癌手术后生存的主要因素。

Competing interests

The authors declare that they have no competing interests.

Competing interests

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