2015 年第 3 期 第 13 卷

12例胸腺非典型类癌的临床分析

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关键词：胸腺肿瘤神经内分泌肿瘤类癌非典型类癌

• 摘要：
• 【摘要】目的 探讨胸腺非典型类癌的临床特点，为胸腺非典型类癌的正确诊断和治疗提供资料并积累经验。方法 收集1999年至2014年期间中国医学科学院肿瘤医院收治的12例胸腺非典型类癌患者的临床和病理资料进行归纳分析，同时文献复习。结果 12例患者临床症状体征无特异性，影像学检查可见前纵隔肿物。10例通过手术切除肿瘤，2例仅做切取活检和穿刺活检。病理及免疫组化诊断胸腺非典型类癌。4例患者未接受辅助治疗，3例患者接受了化疗，2例接受了放疗，2例接受了化疗+放疗，1例接受了放化同步治疗。平均随访时间25.6个月（8-46个月），结果4例患者疾病进展死亡（生存期分别为10、25、39和40个月），3例肿瘤进展后生存，（生存时间分别为43、44、46个月），4例无进展生存（生存期分别为8、10、11、16个月），1例随访9月后失访。结论 胸腺非典型类癌是一种罕见的恶性肿瘤，结合影像学检查并通过手术病理及免疫组化能够明确诊断，手术是首选的治疗方法，预后较差。
• Objective To provide information for proper diagnosis and treatment for thymus atypical carcinoid (TAC) by investigating the clinical characteristics, diagnosis, treatment and prognosis of the disease. Method The retrospective analysis was performed on the data of 12 cases with TAC from 1999 to 2014 in Cancer Hospital of Chinese Academy of Medical Sciences, and review of the literature. Result Although computed tomography scan of the thorax showed the mass, there were nonspecific symptoms and radiological findings in all the 12 patients. 10 of 12 cases accepted surgical resection and 2 excisional biopsy or aspiration biopsy. The definite diagnosis depends on pathology and immunohistochemistry. No adjuvant therapy was performed in 4 patients. Chemotherapy was performed in 3 patients, radiotherapy in 2 patients, chemotherapy plus radiotherapy in 2 patients and radiochemical resynchronization therapy in 1 patent after surgery. The mean follow up time was 25.6 months (8-46 months). 4 patients were found dead after tumor progression (survival time was 10, 25, 39 and 40 months). 3 patients survived after tumor progression (survival time was 43, 44, 46 months). 4 patients had tumor-free survival (survival time was 8, 10, 11, 16 months). 1 patient lost after 9 months follow up. Conclusion Thymus atypical carcinoid is a rare and often misdiagnosed disease. The useful method of diagnosis of TAC depends on the pathology combined with the immunohistochemistry after surgery. Excision surgery is usually an effective means of cure but the prognosis may not be good.