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目的总结原发性颈段气管肿瘤的诊治经验,提高治疗效果。方法回顾性分析1981年1月—2002年12月在中国医学科学院肿瘤医院头颈外科治疗的38例原发性颈段气管肿瘤患者的临床资料。手术治疗26例,单纯放疗12例。气管袖状切除11例;气管壁部分切除13例,其中Ⅰ期气管修复6例;全喉、部分气管和甲状腺腺叶切除2例。结果恶性肿瘤34例,其中腺样囊性癌19例,鳞状细胞癌10例,非霍奇金淋巴瘤2例,低分化癌1例,中分化腺癌1例,小细胞未分化癌1例。颈段气管腺样囊性癌患者3年和5年生存率分别为79·80%和48·36%,鳞状细胞癌分别为80·00%和20·00%。良性肿瘤患者均无瘤生存。治疗后并发症的发生率为18·4%(7/38),其中气管狭窄的发生率11·5%(3/26)。结论原发性气管肿瘤多数为恶性,其中以腺样囊性癌和鳞状细胞癌居多。手术治疗为气管肿瘤首选治疗措施,气管袖状切除为手术方式之一。
Objective To summarize the diagnosis and treatment of primary cervical tracheal tumor and to improve the therapeutic effect. Methods The clinical data of 38 patients with primary cervical tracheal carcinoma treated by head and neck surgeries from January 1981 to December 2002 in Cancer Hospital of Chinese Academy of Medical Sciences were retrospectively analyzed. Surgery in 26 cases, 12 cases of radiotherapy alone. There were 11 cases of tracheal sleeve resection, 13 cases of resection of tracheal wall, 6 cases of stage Ⅰ tracheal repair, 2 cases of total throat, partial tracheal and thyroid lobectomy. Results There were 34 cases of malignant tumors including 19 adenoid cystic carcinomas, 10 squamous cell carcinomas, 2 non-Hodgkin’s lymphoma, 1 poorly differentiated carcinoma, 1 moderately differentiated adenocarcinoma, 1 small cell carcinoma undifferentiated carcinoma 1 example. The 3-year and 5-year survival rates of patients with cervical tracheal adenoid cystic carcinoma were 79.80% and 48.36%, respectively. The rates of squamous cell carcinoma were 80.00% and 20.00% respectively. Patients with benign tumors have tumor-free survival. The incidence of postoperative complications was 18.4% (7/38), of which the incidence of tracheal stenosis was 11.5% (3/26). Conclusion The majority of primary tracheal tumors are malignant, with adenoid cystic carcinoma and squamous cell carcinoma predominate. Surgical treatment for the treatment of tracheal tumor of choice, tracheotomy is one of the surgical methods.