Sherani Khalid, Vakil Abhay, Dodhia Chetan, Fein Alan
aDivision of Pulmonary Medicine, Department of internal medicine, Jamaica Hospital Medical Center, New York bDivision of Critical Care Medicine, Mayo Clinic Rochester, Minnesota cDepartment of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, New York dDivision of Pulmonary and Critical Care, Hofstra Northshore -LIJ School of Medicine, New York, USA.
Curr Opin Pulm Med. 2015 Jul;21(4):322-6. doi: 10.1097/MCP.0000000000000181.
This article reviews the current literature for the purpose of developing a practical approach for the diagnosis and management of primary tracheal tumors.
Because of nonspecific symptoms, tracheal tumors remain a diagnostic challenge. Currently available management strategies are not being optimally utilized due to lack of physician awareness and knowledge. The use of newer diagnostic modalities has increased diagnostic accuracy resulting in earlier detection in recent years. This review describes currently available diagnostic modalities along with relatively newer ones such as virtual bronchoscopy, anatomic Optical Coherence Tomography, spectroscopic techniques, and endobronchial ultrasonography. We will review and discuss management strategies including surgical options, adjuvant therapies, and interventional pulmonary techniques including their role in palliation.
Early detection along with improved surgical and interventional pulmonology techniques has led to a decline in the death rates from tracheal cancer in recent years. However, further studies are required to define the role of chemotherapeutic agents, combination therapies, and novel techniques such as tracheal transplantation, in the management of primary tracheal tumors. More robust evidence-based studies are needed to provide evidence for clinical practice guidelines for the treatment of primary tracheal tumors.
本文回顾当前文献，旨在制定一种原发性气管肿瘤诊断与管理的实用方法。
由于症状不具特异性，气管肿瘤仍是诊断难题。因医生缺乏认识和了解，目前可用的管理策略未得到最佳利用。近年来，使用更新的诊断方法提高了诊断准确性，实现了更早检测。本综述描述了目前可用的诊断方法以及相对较新的方法，如虚拟支气管镜检查、解剖光学相干断层扫描、光谱技术和支气管内超声检查。我们将回顾和讨论管理策略，包括手术选择、辅助治疗以及介入性肺技术，包括它们在缓解症状方面的作用。
近年来，早期检测以及手术和介入性肺科技术的改进导致气管癌死亡率下降。然而，需要进一步研究来确定化疗药物、联合治疗以及气管移植等新技术在原发性气管肿瘤管理中的作用。需要更有力的循证研究为原发性气管肿瘤治疗的临床实践指南提供证据。
