Pulmonary carcinoid - Presentation, diagnosis, and outcome in 142 cases in Israel and review of 640 cases from the literature
Pulmonary carcinoid - Presentation, diagnosis, and outcome in 142 cases in Israel and review of 640 cases from the literature
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DOI：
10.1378/chest.119.6.1647
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发表时间：
2001-06-01
期刊：
影响因子：
9.6
通讯作者：
Kramer, MR
中科院分区：
文献类型：
--
作者：
Fink, G;Krelbaum, T;Kramer, MR
目的：明确以色列肺类癌的特征和转归。方法：回顾性分析近20年来以色列四家主要医院患者的临床病理资料和转归。结果：共有142例肺类癌病例：典型（n = 128）和非典型（n = 14）。我们计算出每 100 万人口中每年约有 2.3 至 2.8 例病例。女性与男性患者的比例为1.6：1。典型类癌患者的吸烟率与一般人群相似，非典型组的吸烟率是非典型组的两倍。支气管阻塞是大多数症状和体征的原因，包括阻塞性肺炎、胸膜炎性疼痛、肺不张和呼吸困难（41%）。类癌综合征极为罕见，仅发生在一名转移性疾病患者中。大多数肿瘤（68%）发生在主支气管，52%的患者通过纤维支气管镜进行诊断，没有支气管内出血的证据，非典型组中淋巴结受累和远处转移的发生率分别为57%和21%，典型组中分别为10%和3%。选择的治疗方法是手术：肺叶切除术（56%）或全肺切除术（16%）。典型和非典型肿瘤患者的5年生存率分别为89%和75%（不显着），10年生存率分别为82%和56%（p < 0.05）。对大量文献进行了回顾。结论：肺类癌是以色列人群中一种罕见的肿瘤。通过早期诊断和积极的手术治疗，长期预后良好。
Objective: To determine the characteristic features and outcome of pulmonary carcinoid tumors in Israel.Methods: Retrospective analysis of the clinicopathologic data and outcome of patients from four major hospitals in Israel in the last 20 years.Results: There were 142 cases of pulmonary carcinoid tumors: typical (n = 128) and atypical (n = 14). We calculated an annual incidence of about 2.3 to 2.8 cases per 1 million population. The ratio of female to male patients was 1.6:1. The prevalence of smoking was similar to the general population in patients with typical carcinoids and twice as high in the atypical group. Bronchial obstruction was the cause of most of the presenting symptoms and signs and included obstructive pneumonitis, pleuritic pain, atelectasis, and dyspnea (41%). Carcinoid syndrome was extremely rare and occurred in only one patient with metastatic disease. Most of the tumors (68%) arose in the major bronchi, Diagnosis was made using fiberoptic bronchoscopy in 52% of patients without evidence of endobronchial hemorrhage, Nodal involvement and distant metastases occurred in 57% and 21%, respectively, in the atypical group, and 10% and 3%, respectively, in the typical group. The treatment of choice was surgical: lobectomy (56%) or pneumonectomy (16%), The respective 5-year survival rates for patients with typical and atypical tumors were 89% and 75% (not significant), and the 10-year survival rates were 82% and 56% (p < 0.05). A review of large series from the literature is presented.Conclusion: Pulmonary carcinoid is an uncommon tumor in the Israeli population. With early diagnosis and aggressive surgical therapy, long-term prognosis is excellent.