Clinical analysis of 8 cases of tracheal adenoid cystic carcinoma

Abstract

气管腺样囊性癌是一种少见的原发于气管的低度恶性肿瘤,临床易误诊、漏诊。本研究拟提高对气管腺样囊性癌的认识。方法 回顾我院2001年至2007年经组织病理学证实的8例气管腺样囊性癌的临床表现、治疗、随访。结果 患者的主要临床表现为咳嗽、咯血、喘鸣及进行性的呼吸困难。CT及纤维支气管镜检查有助于明确诊断。5例患者行手术治疗;3例行纤维支气管镜下高频电切术治疗,1例复发后再行手术;2例术后行化疗。1例失访;1例电切术后11个月死亡;余6例随访2～34个月均健在。结论 气管腺样囊性癌恶性程度低,患者预后好。手术为首选治疗。内镜下治疗为局部姑息性治疗,可缓解症状、提高生活质量。

Background and objective Tracheal adenoid cystic carcinoma （TACC） is a rare, low malignant and primary tracheal carcinoma, which is easily misdiagnosed and missedly diagnosed. The aim of this study is to increase the knowledge about TACC. Methods Data including clinical manifestations and treatment were retrospectively analyzed for 8 cases of TACC confirmed by pathology and follow-up was carried out. Results The main manifestations were cough, stridor, hemoptysis and progressive inspiratory dyspnea. Fiberoptic bronchoscope and computerized tomography were reliable examinations for final diagnosis. Five cases underwent operative treatment, and three cases underwent interventional treatment by fiberoptic bronchoscope in which 1 case accepted a second operation after recurrence and 2 cases accepted chemotherapy after operation. One case was lost, 1 case treated by interventional treatment died after 11 months and other 6 cases were followed-up from 2 months to 34 months who were alive. Conclusion TACC is low malignancy and has good prognosis. The best treatment is operation. The better palliative treatment is interventional treatment by fiberoptic bronchoscope which can relieve symptoms and improve the patient’s living quality.