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气管支气管黏液表皮样癌的预后因素——15年经验

Prognostic factors of tracheobronchial mucoepidermoid carcinoma--15 years experience.

作者信息

Chin Chien-Hung, Huang Chao-Cheng, Lin Meng-Chih, Chao Tung-Ying, Liu Shih-Feng

机构信息

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Niao-Sung Hsiang, Kaohsiung Hsien, Taiwan.

出版信息

Respirology. 2008 Mar;13(2):275-80. doi: 10.1111/j.1440-1843.2007.01207.x.

Abstract

BACKGROUND AND OBJECTIVES

Mucoepidermoid carcinoma of the tracheobronchial tree is a rare tumour which displays a variable degree of clinical aggressiveness and malignancy. The relationship between the patient's prognosis and the tumour's histological features and clinical behaviour is uncertain. The aim of this study was to identify the clinicopathological features and analyse the outcomes of patients with this type of cancer.

METHODS

A retrospective analysis of the medical records of patients diagnosed with mucoepidermoid carcinoma of the lung between 1991 and 2006 was conducted.

RESULTS

The study comprised 15 patients. Higher histological grade tumours had a higher proportion of squamoid cells (P = 0.019); the tumours of patients with lymph node metastases also had a higher proportion of squamoid cells than did the tumours of patients without lymph node metastases (P = 0.015). Patients with early stage tumours (stage IA, IB, IIB) had better outcomes (10-year survival rate = 87.5%), than did patients with late-stage tumours (stage IIIB, IV) (1-year survival rate = 28.6%; 2-year survival rate = 0%, P = 0.001). Patients with lower-grade tumours (grade 1 and grade 2) had better outcomes (1-year survival rate = 80%; 5-year survival rate = 57.1%) than did patients with higher-grade tumours (grade 3) (1-year survival rate = 20%, P = 0.035). Tumour staging was a significant independent predictor of survival on Cox proportional hazards analysis.

CONCLUSIONS

The proportion of squamoid cells on tumour histology may be an indicator of the level of tumour malignancy. Tumour, node, metastasis staging is a significant determinant of prognosis in patients with tracheobronchial mucoepidermoid carcinoma.

摘要

背景与目的

气管支气管树黏液表皮样癌是一种罕见肿瘤,其临床侵袭性和恶性程度各异。患者预后与肿瘤组织学特征及临床行为之间的关系尚不确定。本研究旨在确定此类癌症患者的临床病理特征并分析其预后。

方法

对1991年至2006年间诊断为肺黏液表皮样癌的患者病历进行回顾性分析。

结果

该研究纳入15例患者。组织学分级较高的肿瘤鳞状细胞比例更高(P = 0.019);有淋巴结转移患者的肿瘤鳞状细胞比例也高于无淋巴结转移患者的肿瘤(P = 0.015)。早期肿瘤(IA期、IB期、IIB期)患者的预后(10年生存率 = 87.5%)优于晚期肿瘤(IIIB期、IV期)患者(1年生存率 = 28.6%;2年生存率 = 0%,P = 0.001)。低级别肿瘤(1级和2级)患者的预后(1年生存率 = 80%;5年生存率 = 57.1%)优于高级别肿瘤(3级)患者(1年生存率 = 20%,P = 0.035)。在Cox比例风险分析中,肿瘤分期是生存的重要独立预测因素。

结论

肿瘤组织学上鳞状细胞的比例可能是肿瘤恶性程度的一个指标。肿瘤、淋巴结、转移分期是气管支气管黏液表皮样癌患者预后的重要决定因素。

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