肺癌心包转移43例临床分析

Clinical analysis of 43 cases with pericardial metastasis from lung cancer

  • 摘要: 目的:探讨支气管肺癌心包转移病例的临床特点,诊断和治疗。方法:复习我院1960年1月~1994年2月收治的肺癌996例(复治病例除外),对其中伴心包转移的43例进行回顾性分析。结果:经病理组织学和/或细胞学证实腺癌30例,小细胞癌8例,鳞癌5例。3例以心包积液为首发征象就诊,经心包穿刺抽液找到腺癌细胞。经心包穿刺抽液、心包腔内注入抗癌药物治疗心包压塞8例,平均生存了234d。腺癌患者血浆、心包积液中CEA显著增高。结论:腺癌易心包转移,CEA具有较重要诊断价值。早期诊断,积极抽液和心包腔化疗,可提高生命质量和延长生存期。

     

    Abstract: Objective:To appoach the clinical features, diagnosis and treatment of pericardialmetastasis in broncho-lung cancer.Methods:The 996 cases of lung cancer (not counting readmission patients) were reviewed in our hospital during January 1960 to February 1994, among which 43 cases of pericardial metastasis were analysed retrospectively. Results:By means of histopathology and/or exfoliative cytology, 30 cases of adenocarcinoma, 8 cases of small cell lung cancer and 5 cases of squamous carcinoma were revealed. There were 3 patients who took hydropericardium as the first symptom and the adenocarcinoma cells were found in the pericardial effusion. Treated with pericardiocentesis and injecting antineoplastics into pericardial cavity, 8 patients with pericardial tamponade relieved and survived for the average time of 234 days. The carcinoembryonic antigen(CEA) increased significantly in blood plasma and pericardial effusion in patients the adenocarcinoma. Conclusion:Adenocarcinoma was liable to metastasize to the pericardium, to which CEA had an important diagnostic value. It was proved that early diagnosis, positive pericardiocentesis and chemotherapy could improve the living quality and prolong subsisting time of the patients.

     

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