Chapleau D, Pagé A, Verdant A, Beauchamp G, Nakhlé G
Department of Surgery, Université de Montréal, PQ.
Can J Surg. 1991 Apr;34(2):111-4.
Between 1962 and 1987 bronchial carcinoids were diagnosed in 41 patients (21 men, 20 women) at l'Hôpital du Sacré-Coeur and the Centre hospitalier Maisonneuve-Rosemont. The patients ranged in age from 19 to 73 years (mean 47 years). Fourteen of the 19 asymptomatic carcinoids were discovered on routine chest radiography. Twenty-two symptomatic patients presented with either pneumonia or hemoptysis. Tumours involved the right and left lungs equally. Thirty tumours were located centrally and 11 peripherally. Sensitivity of endoscopic biopsy specimens was 66%. No complications occurred during biopsy. Cytologic examination of sputum, lavage, brushing and transthoracic biopsy specimens was of no value in establishing the diagnosis. Thirty-seven patients underwent surgical resection: lobectomies (26, 3 with bronchoplasties), pneumonectomies (7), segmentectomies (2) and wedge resections (2). One patient (3%) died, and there was one major complication (3%) related to surgery. The mean follow-up was 8 years. The probability of survival was 97% +/- 3 at 5 years and 92% +/- 6 at 10 years. None of the 19 patients treated for a peripheral tumour died, but two patients who had centrally located tumours that exhibited transbronchial invasion and lymph-node metastasis died. No prognostic information could be gained from tumour size or type. A statistical association was found between transbronchial invasion and lymph-node metastasis. Bronchial carcinoids are low-grade malignant tumours. Resection should be conservative, but lymph-node involvement requires a more radical approach.
1962年至1987年间，圣心医院和迈松纳夫-罗斯蒙特中心医院共诊断出41例支气管类癌患者（21名男性，20名女性）。患者年龄在19岁至73岁之间（平均47岁）。19例无症状类癌中有14例是在常规胸部X线检查时发现的。22例有症状的患者表现为肺炎或咯血。肿瘤累及左右肺的比例相同。30个肿瘤位于中央，11个位于外周。内镜活检标本的敏感性为66%。活检过程中未发生并发症。痰液、灌洗、刷检和经胸活检标本的细胞学检查对确诊没有价值。37例患者接受了手术切除：肺叶切除术（26例，3例伴有支气管成形术）、全肺切除术（7例）、肺段切除术（2例）和楔形切除术（2例）。1例患者（3%）死亡，有1例严重并发症（3%）与手术有关。平均随访时间为8年。5年生存率为97%±3%，10年生存率为92%±6%。19例接受外周肿瘤治疗的患者均未死亡，但2例中央型肿瘤伴有经支气管侵犯和淋巴结转移的患者死亡。肿瘤大小或类型无法提供预后信息。经支气管侵犯与淋巴结转移之间存在统计学关联。支气管类癌是低度恶性肿瘤。手术切除应保守，但淋巴结受累则需要更积极的治疗方法。
