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介入肺科在肾细胞癌支气管内转移中的作用。

The role of interventional pulmonology in endobronchial metastasis of renal cell carcinoma.

作者信息

Doğan Deniz, Turan Demet, Özgül Mehmet Akif, Çetinkaya Erdoğan

机构信息

Department of Chest Diseases, University of Health Science, Gulhane Training and Research Hospital, Ankara, Turkey.

Department of Chest Diseases, University of Health Science, Yedikule Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul, Turkey.

出版信息

Tuberk Toraks. 2019 Sep;67(3):211-218. doi: 10.5578/tt.68407.

Abstract

INTRODUCTION

Although metastasis of extrapulmonary solid organ malignant tumors to the lungs is very common, endobronchial metastases are very rare. The most common extrapulmonary tumors that make endobronchial metastases are breast, kidney and colorectal carcinomas.

MATERIALS AND METHODS

In this study, we retrospectively examined the data of eleven renal cell carcinoma patients who underwent endobronchial metastases in an eight-year period.

RESULT

Ten of the patients were male and the mean age was 55 ± 1 (41-71) years. The most common symptom was cough (45.5%, n= 5), on the other hand 18.2% (n= 2) of the patients had no complaints. Right bronchial system, left bronchial system and tracheal distribution rates of endobronchial lesions were 45.5% (n= 5), 63.6% (n= 7) and 27.3% (n= 3) respectively. The mean time from diagnosis of primary renal cell carcinoma to endobronchial metastases was 47.5 ± 32 (5.2-100.5) months. A total of twenty two interventional procedures were performed. All except one patient underwent endobronchial treatment. Argon plasma coagulation was most commonly used as the endobronchial metastases option (n= 10, 100%). The mechanical resection (n= 6, 60%), laser (n= 5, 50%), cryoextraction (n= 5, 50%) and cryotherapy (n= 4, 40%) methods were used other than argon plasma coagulation. The mean survival time was 19.4 ± 15.7 (3.2-40.5) months after endobronchial metastases and 54.0 ± 40.4 (8.7-107.6) months after renal cell carcinoma diagnosis.

CONCLUSIONS

Extrathoracic malignancy that most metastasis to the airways is renal cell carcinoma. Endobronchial treatment procedures for endobronchial metastasis of renal cell carcinoma can be performed with low complication rates.

摘要

引言

尽管肺外实体器官恶性肿瘤转移至肺部很常见,但支气管内转移却极为罕见。导致支气管内转移的最常见肺外肿瘤是乳腺癌、肾癌和结直肠癌。

材料与方法

在本研究中,我们回顾性分析了8年间11例发生支气管内转移的肾细胞癌患者的数据。

结果

10例患者为男性,平均年龄为55±1(41 - 71)岁。最常见的症状是咳嗽(45.5%,n = 5),另一方面,18.2%(n = 2)的患者无任何不适。支气管内病变在右支气管系统、左支气管系统和气管的分布率分别为45.5%(n = 5)、63.6%(n = 7)和27.3%(n = 3)。从原发性肾细胞癌诊断到支气管内转移的平均时间为47.5±32(5.2 - 100.5)个月。共进行了22次介入手术。除1例患者外,所有患者均接受了支气管内治疗。氩等离子体凝固术是最常用的支气管内转移治疗方法(n = 10,100%)。除氩等离子体凝固术外,还使用了机械切除(n = 6,60%)、激光(n = 5,50%)、冷冻提取(n = 5,50%)和冷冻疗法(n = 4,40%)等方法。支气管内转移后平均生存时间为19.4±15.7(3.2 - 40.5)个月,肾细胞癌诊断后平均生存时间为54.0±40.4(8.7 - 107.6)个月。

结论

最常转移至气道的胸外恶性肿瘤是肾细胞癌。肾细胞癌支气管内转移的支气管内治疗手术并发症发生率较低。

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