Résumé
Objective:We aimed to explore the clinical features, computed tomography (CT) findings, treatment, and prognosis of bronchopulmonary carcinoid. Methods:Clinical data of 31 patients with primary carcinoid tumor of the lung were retrospectively re-viewed. The prognostic factors were analyzed via Cox univariate and multivariate analyses. Results: Clinical symptoms included coughing or expectoration in 17 of the 31 cases, hemoptysis or blood-stained sputum in 7 cases, and chest pains or shortness of breath in 8 cases. Six cases were asymptomatic. The CT scans showed round or oval nodules with clear boundaries, and enhancement CT scans indicated mild, homogeneous enhancement. Immunohistochemistry results revealed the positive expression rates of synaptophy-sin (Syn), chromogranin A (CgA), and neuron-specific enolase (NSE) were 90.3%(28/31), 87.1%(27/31), and 90.3%(28/31), respec-tively. Therapy and prognosis results were as follows:28 of the total number of patients underwent surgery, among which 3 underwent postoperative adjuvant therapy, 2 received chemotherapy; and only 1 refused treatment. The 1-year overall survival rates were 100%(18/18) and 92.3%(12/13), whereas the 3-year survival rates were 94.4%(17/18) and 69.2%(9/13) in the typical and atypical carcinoid cases, respectively. Cox univariate analysis results revealed that lymphatic metastasis (P=0.02), tissue types (P=0.017), TNM stage (P=0.005), and therapies (P=0.01) were the prognostic factors. Cox multivariate analysis results showed that lymphatic metastasis (P=0.032) and tissue types (P=0.002) were the independent prognostic factors. Conclusion:Compared with other lung cancers, the bron-chopulmonary lung carcinoid has no special clinical manifestation in clinical and radiographic images. The diagnosis was mainly based on histopathology results. Surgery was the main and effective treatment, whereas chemotherapy and radiotherapy showed unsatisfactory results. The overall prognosis was satisfactory. However, the atypical carcinoid was inferior to the typical carcinoid in terms of progno-sis. Pathological typing and lymph node metastasis were significant prognostic factors.
Résumé
Objective To investigate the influence and clinical effect of assisted three-dimensional conformal radiation therapy (3D-CRT ) on obstructive jaundice caused by malignant tumors .Methods 90 cases with obstructive jaundice caused by malignant tumors of liver ,gallbladder and pancreases were randomly divided into observation group and control group ,45 cases in each group . Patients in control group were given comprehensive measures ,including tumors exairesis ,assisted chemotherapy and stereotactic ra-diotherapy ,and patients in observation group were given 3D-CRT based on tumors exairesis and assisted chemotherapy .Clinical effect ,serum bilirubin were observed 2 months after treatment ,adverse reactions were recorded during the treatment ,and survival rate in 2-year follow up in two groups were observed .Results Total effective rate in observation group and control group were 75 .56% and 57 .78% (P<0 .05) ,respectively ,and adverse reactions rate were 37 .78% and 57 .78% (P<0 .05) ,respectively .After treatment ,serum total bilirubin and direct bilirubin in two groups were all lower than those before treatment (P<0 .05) .Serum total bilirubin and direct bilirubin in observation group after treatment were (26 .3 ± 6 .5)μmol/L and(18 .9 ± 3 .3)μmol/L ,and were (39 .3 ± 9 .5)μmol/L and(26 .9 ± 6 .7)μmol/L in control group ,and there were statistical difference between two groups (P<0 .05) . Observation group′s survival rate was higher than that of control group (P<0 .05) .Conclusion It has good clinical effect of trea-ting obstructive jaundice caused by malignant tumors by 3D-CRT ,and it prolongs the survival time ,decreases serum bilirubin and improves jaundice symptom ,so it has some guiding significance to its treatment .