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目的 总结原发性肺肉瘤的外科治疗经验 ,提高诊治水平。 方法 手术治疗 49例中肺叶切除或袖式肺叶切除 32例 ,全肺切除 11例 ,局部切除 3例 ,手术探查 3例。病理类型 :恶性纤维组织细胞瘤 13例 ,纤维肉瘤 9例 ,癌肉瘤 9例 ,恶性血管外皮细胞瘤 7例 ,肺胚瘤 5例 ,平滑肌肉瘤 4例 ,恶性间皮细胞瘤和非何杰金氏淋巴瘤各 1例。 结果 手术死亡 2例 ,全组生存期中位数为 19个月 ,3年生存率 19% ,5年生存率 12 % ;2年死亡率 6 7%。结论 原发性肺肉瘤是少见的肺内恶性肿瘤 ,易误诊 ,预后差。外科治疗为首选治疗方式。其预后与肿瘤大小 ,外侵程度及是否有淋巴结转移有关。
Objective To summarize the surgical treatment experience of primary pulmonary sarcoma and improve the diagnosis and treatment. Methods Surgical treatment was performed in 32 patients with lobectomy or sleeve lobectomy in 32 cases, pneumonectomy in 11 cases, local resection in 3 cases, and surgical exploration in 3 cases. Pathological types: 13 cases of malignant fibrous histocytoma, 9 cases of fibrosarcoma, 9 cases of carcinosarcoma, 7 cases of malignant hemangiopericytoma, 5 cases of pulmonary embolism, 4 cases of leiomyosarcoma, malignant mesothelioma, and non-Hodgkin 1 case of lymphoma. Results The operative death occurred in 2 cases. The median survival time was 19 months, the 3-year survival rate was 19%, the 5-year survival rate was 12%, and the 2-year mortality rate was 67%. Conclusions Primary pulmonary sarcoma is a rare malignant tumor in the lung, which is easily misdiagnosed and has a poor prognosis. Surgical treatment is the preferred treatment. Its prognosis is related to tumor size, degree of external invasion and whether there is lymph node metastasis.