A Retrospective Analysis On61Cases Of Clinical Diagnosis And Therapy Of Bronchopulmonary Carcinoid

Objective: To improve the level of recognition, diagnosis and therapythrough analyzing the clinical data of bronchopulmonary carcinoid.Methods: The data of61cases of pathologically confirmedbronchopulmonary carcinoid (hereafter called pulmonary carcinoid) fromJan1997to Jan2013were analysed retrospectively. The data includeclinical manifestations, imaging features, diagnosis and treatment, etc. Thepatients’ survival time were investigated through telephone follow-up. Alldatas were analyzed by SPSS13.0statistical software to explore therelationship between prognosis and the factors such as tumor location, size,pathological type, TNM stage,lymph node metastasis, smoking, familyhistory of cancer and age, etc.Results: Among61cases of pulmonary carcinoid,39weremales(63.9%) and22females (36.1%), aged29~88years old. The course ofdisease ranged from2days to24months, with an average of5.3mongths.Of all the cases, there were39of TC (63.9%) and22of AC (36.1%). Rightlobe was the most common site of lesion in34of61cases (55.7%). All thecases consisted of central type in33(54.1%)and peripheral type in28(45.9%), in which, cough (88.5%), expectoration (77.0%), chest distress(63.9%) and shortness of breath (49.2%) were the most common symptoms,without special clinical manifestation. The common examinations wereperformed on58cases by chest CT (95.1%) and48by X-ray(78.7%).1casewith distant metastasis was diagnosed by ultrasound,1by CT, and2by ECT.The serum levels of CEA, NSE and CYFRA21-1were detected in26cases,in which7had elevated level of CA199,3had elevated level of NSE, and1had increased level of CYFRA21-1. Fiberoptic bronchoscope was performed in28cases and21were undertaken endoscopic biopsy. As a result,6caseswere pathologically diagnosed as carcinoid and the positive biopsy rate was28.6%. Another2cases were diagnosed by percutaneous lung biopsy, withthe remaining53cases diagnosed by operation and biopsy.55casesprefered surgical resection and26out of them received systemicchemotherapy. Due to some factors, the remaining6cases received medicalcomprehensive therapy mainly consisted of radiotherapy and chemotherapy.53cases were followed up for6-136months, with8(13.1%) lost. The1,3,and5years overall survival rate were85.8%,71.2%and57.7%respectively. Single factor analysis showed that there were no significantdifferences in1,3,and5years survival rate among different factors such astumor location, size, family history of cancer and age (P>0.05), butsignificant differences were found between different pathological type. Itaslo showed that there were significant differences in3and5years survivalrate among different TNM stages, as well as in5years survival rate betweenfactors such as lymph node metastasis and smoking (P<0.05). Multiplefactor analysis indicated that there were significant differences in thesurvival rate of pulmonary carcinoid among different factors such ashistological type, TNM stages and lymph node metastasis (P<0.05).Conclusion:1.Lack of characteristic clinical manifestations, pulmonarycarcinoid are easy to be misdiagnosed. Immunohistochemistry can help tomake final diagnosis and distinguish the subtypes.2. Surgery is thepreferred treatment for pulmonary carcinoid. Good prognosis and highsurvival rate can be achieved in the early typical carcinoid tumor withoutlymph node metastasis.