Attar S, Miller J E, Hankins J, Thompson B W, Suter C M, Kleger P J, McLaughlin J S
Ann Thorac Surg. 1985 Aug;40(2):126-32. doi: 10.1016/s0003-4975(10)60004-5.
The cases of 51 patients with bronchial adenomas were reviewed. There were 43 bronchial carcinoids, 5 adenoid cystic carcinomas, 2 mixed tumors, and 1 mucoepidermoid carcinoma. The carcinoid group was divided into typical (31, 72%) and atypical (12, 28%) subgroups. Nine carcinoids (20%) were categorized as metastasizing adenomas; in this group, 7 lesions were atypical and 2 were typical. Thirty-two lobectomies, 7 bilobectomies, 8 pneumonectomies, 2 sleeve resections, and 2 tracheal resections were performed. Ten-year survival was 88% for patients with typical carcinoids and 59% for those with atypical carcinoids. In the group with adenoid cystic carcinoma, 1 patient died postoperatively, 1 had recurrence of the tumor, 2 were alive and free from disease 16 and 23 years later, and 1 died of heart disease at 11 years. The patient with mucoepidermoid carcinoma was alive without recurrence 15 years after operation. In conclusion, bronchial adenomas of the carcinoid type are potentially malignant. Their prognosis depends on the histology of the tumor, and on the presence of metastasis to the regional lymph nodes and distant organs.
回顾了51例支气管腺瘤患者的病例。其中有43例支气管类癌、5例腺样囊性癌、2例混合瘤和1例黏液表皮样癌。类癌组又分为典型(31例,72%)和非典型(12例,28%)亚组。9例类癌(20%)被归类为转移性腺瘤;在该组中,7个病灶为非典型,2个为典型。实施了32例肺叶切除术、7例双肺叶切除术、8例全肺切除术、2例袖状切除术和2例气管切除术。典型类癌患者的10年生存率为88%,非典型类癌患者为59%。在腺样囊性癌组中,1例患者术后死亡,1例肿瘤复发,2例在16年和23年后存活且无疾病,1例在11年时死于心脏病。黏液表皮样癌患者术后15年存活且无复发。总之,类癌型支气管腺瘤具有潜在恶性。其预后取决于肿瘤的组织学类型,以及区域淋巴结和远处器官有无转移。