Roeslin N, Gasser B, Popin E, Warter A, Wihlm J M, Morand G, Witz J P
Service de Chirurgie Thoracique, CHU de Strasbourg.
Ann Chir. 1990;44(8):632-5.
The pathological and clinical features of 62 carcinoid tumours of the bronchus operated between 1975 and 1987 were reviewed in order to determine the prognostic value of certain parameters: limit of proliferation, vascular invasion, lymph node involvement. This series corresponded to 36 central tumours and 25 peripheral tumours, all treated surgically. One patient was lost to follow-up, 3 developed recurrences, 56 are still alive without recurrence and 3 died from intercurrent causes. The histological appearance of the tumours was homogeneous and typical. Twenty-eight lesions were strictly intrabronchial, 34 invaded the lung with incomplete limits in twenty cases. The tumour showed signs of vascular invasion in ten cases and the adjacent lymph nodes were invaded in eight cases. The local recurrence was undoubtedly related to an excessively conservative primary resection, as the primary tumour did not demonstrate any unusual features. The two tumours which metastasized showed vascular invasion: one metastasized to a hilar node, but these features were observed in other cases which retained a benign course. The standard histological diagnosis of typical carcinoid tumour does not appear to raise any particular difficulties; it is reliable. The course of the disease is sometimes malignant but no histological parameter is able to accurately predict this outcome.
回顾了1975年至1987年间接受手术治疗的62例支气管类癌肿瘤的病理和临床特征，以确定某些参数的预后价值：增殖极限、血管侵犯、淋巴结受累情况。该系列包括36例中央型肿瘤和25例周围型肿瘤，均接受了手术治疗。1例患者失访，3例出现复发，56例仍存活且无复发，3例死于并发疾病。肿瘤的组织学表现均一且典型。28个病变严格局限于支气管内，34个侵犯肺组织，其中20例边界不清。10例肿瘤有血管侵犯迹象，8例侵犯邻近淋巴结。局部复发无疑与过于保守的初次切除有关，因为原发肿瘤未显示任何异常特征。发生转移的2例肿瘤均有血管侵犯：1例转移至肺门淋巴结，但在其他病程为良性的病例中也观察到了这些特征。典型类癌肿瘤的标准组织学诊断似乎没有任何特别困难；它是可靠的。疾病进程有时为恶性，但没有任何组织学参数能够准确预测这一结果。
