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"胸腺类癌" 2 results
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Objective To investigate and evaluate the clinical manifestation, classification, surgical management and postoperative adjuvant therapy of thymic carcinoid, so as to improve the knowledge of the disease. Methods From January 1980 to January 2006, the outcome of surgery and follow-up of 18 cases of thymic carcinoid surgically intervened were retrospectively analysed. In this series, there were 2? exploratory thoracotomy, 2 partial or incomplete resection and 14 complete resections, which included 2 superior vena cava removal and reconstruction. The survival probabilities were calculated by the life tables, and a multivariable analysis of prognosis factors for thymic carcinoid was carried out using Cox regression model. Results Two patients who underwent exploratory thoracotomy died within one year and two years postoperatively respectively, 2 with partial or incomplete resection obtained temporary symptomatic improvement, 1 of 14 performed complete resections associated with Cushing’s syndrome died of septicemia in two weeks postoperatively, and the other 13 cases were in good condition by follow-up of 5 months to 15 years. The survival rate of 3, 5 and 10 years were 72.6%, 60.5% and 40.3%, respectively. According to Cox regression analysis, the factors of influence upon prognosis included lymph node metastasis(P=0047), pathological type(P=0.000), mode of resection (P=0.000) and postoperative adjuvant treatment(P=0018). Conclusion The thymic carcinoid is different from thymoma or thymic carcinoma, and there exist some difficulty in differential diagnosis. It is divided into typical and atypical thymic carcinoid in pathology, There are obvious differences in clinical manifestation and prognosis between typical and atypical carcinoid. The atypical thymic carcinoid has higher malignancy, frequent recurrence or metastasis, and poor prognosis. Complete resection of tumor with the involved surroundings could improve the long-term survival. The adjuvant radiotheraphy and chemotheraphy postoperatively would be benefit to the patients.
Release date:2016-08-30 06:16
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目的:总结胸腺类癌的临床表现、病理特征、CT表现及其临床价值。方法:对本院收治的2例胸腺类癌进行分析并结合文献复习。结果:胸腺类癌发病率低,大部分早期患者无临床症状,经胸部X线、CT检查时发现;中晚期始出现症状。病理检查出类癌后,电镜可见神经内分泌颗粒,免疫组化显示神经特异性烯醇化酶、肿瘤嗜铬蛋白A、促皮质素阳性。胸部CT表现特征为起于前上纵隔肿块,常位于心底部大血管和心包周围,肿块内密度不均,可见钙化,增强后轻中度强化,易发生胸内外转移。结论:胸腺类癌是一罕见的前纵隔肿瘤,根据CT特征,结合临床可有助诊断、指导手术、推测预后,因此CT在临床诊治中有非常重要的价值。
Release date:2016-09-08 09:54
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