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頁籤選單縮合
題名 | Endobronchial Metastatic Disease=氣管內轉移病灶 |
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作者 | 王逸熙; 王瑞隆; 賴永發; 林安伸; 張學文; | 書刊名 | 長庚醫學 |
卷期 | 22:2 1999.06[民88.06] |
頁次 | 頁240-245 |
分類號 | 415.412 |
關鍵詞 | 支氣管鏡; 黑色素瘤; 氣管內轉移; 鼻咽癌; Bronchoscope; Endobronchial metastasis; Melanoma; Nasopharyngeal carcinoma; |
語文 | 英文(English) |
中文摘要 | 背景:惡性腫瘤轉移至肺部是很常見的,但是合併氣管內轉移卻是少見的。氣管 內轉移的病人預後通常不好,但是少數病人經過積極治療後,有較好的預後。方法:本文回顧 高雄長庚醫院 10 年的支氣管鏡報告,發現有 40 例惡性腫瘤合併有氣管內轉移的病人。由 病人原發腫瘤、病人的年齡、氣管內轉移的部位來分析病人的預後。結果:病人包括 16 例 頭頸部腫瘤,10 例大腸癌,6 例乳癌,4 例子宮頸癌, 2 例黑色素瘤, 1 例甲狀腺癌,1 例胃癌。原發腫瘤是鼻咽癌的病人預後較好,年齡起過 70 歲的病人預後較差,轉移病灶在 主支氣管的病人預後也不好。結論:這類病人預後通常是不好的,但是對於單一病灶的氣管 內轉移,而且沒有其他部位的轉移,有些病人經過開刀切除後會有較好的預後。對於有惡性 腫瘤病史的病人,出現呼吸道的症狀,不管胸部x光的發現是什麼,都有可能出現氣管內轉 移的病灶,對於這些病人,我們都必須考慮幫他們做氣管鏡檢查。 |
英文摘要 | Background:Endobronchial metastasis (EM) is rare. Patients with EM are in advanced stages of disease and have poor prognoses. However, some patients have had long-term survival after aggressive treatment. Methods: We retrospectively reviewed the records of 9678 patients who had undergone bronchoscopic procedures. Forty patients were diagnosed as having EM. Results:The most common site of primary tumors was the head and neck [10 nasopharyngeal carcinomas (NPC), 2 buccal cancers, 2 glossal cancers, 2 laryngeal cancers]. Clinical manifestations included cough (50%), hemoptysis (20%), dyspnea (15%), and absence of respiratory symptoms (15%). The most common findings in chest roentgenograms (CXR) were single masses (40%). The median length of survival for all patients was 12 months (range, 6 to 18 months). The median length of survival in patients whose ages were over 70 years was 1 months and in patients less than 70 years old it was 12 months (range, 7 to 19 months) (p=0.002). In patients whose EM extent was to the main bronchus, the median length of survival was 1 month (range, 1 to 3 months) and that in those whose EM did not extend to main bronchus was 12 months (range, 11 to 21 months) (p=0.004). In patients whose primary tumors were due to head and neck cancer other than NPC, the survival time was 1 month (range, 1 to 11 months), and in others it was 12 months (range, 7 to 19 months) (P=0.0008). Conclusion:Three factors contributed to a poor prognosism, including the patient's age being over 70 years, primary tumors due to head and neck cancer other than NPC, and extension of the endobronchial metastatic lesion to the main bronchus. |
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