文章：

支气管镜下肺减容术治疗异质性肺气肿后，非小细胞肺癌的肺切除术

Lung Resection for Non-Small Cell Lung Cancer following Bronchoscopic Lung Volume Reduction for Heterogenous Emphysema

原文发布日期：31 January 2024

DOI: 10.3390/cancers16030605

类型: Article

开放获取: 是

英文摘要：

Bronchoscopic lung volume reduction (BLVR) is a minimally invasive treatment for emphysema. Lung cancer may be associated with emphysema due to common risk factors. Thus, a growing number of patients undergoing BLVR may develop lung cancer. Herein, we evaluated the effects of lung resection for non-small cell lung cancer in patients undergoing BLVR. The clinical data of patients undergoing BLVR followed by lung resection for NSCLC were retrospectively reviewed. For each patient, surgical and oncological outcomes were recorded to define the effects of this strategy. Eight patients were included in our series. In all cases but one, emphysema was localized within upper lobes; the tumor was detected during routine follow-up following BLVR and it did not involve the treated lobe. The comparison of pre- and post-BLVR data showed a significant improvement in FEV1 (29.7 ± 4.9 vs. 33.7 ± 6.7,p= 0.01); in FVC (28.5 ± 6.6 vs. 32.4 ± 6.1,p= 0.01); in DLCO (31.5 ± 4.9 vs. 38.7 ± 5.7,p= 0.02); in 6MWT (237 ± 14 m vs. 271 ± 15 m,p= 0.01); and a reduction in RV (198 ± 11 vs. 143 ± 9.8,p= 0.01). Surgical resection of lung cancer included wedge resection (n= 6); lobectomy (n= 1); and segmentectomy (n= 1). No major complications were observed and the comparison of pre- and post-operative data showed no significant reduction in FEV1% (33.7 ± 6.7 vs. 31.5 ± 5.3;p= 0.15) and in DLCO (38.7 ± 5.7 vs. 36.1 ± 5.4;p= 0.15). Median survival was 35 months and no cancer relapses were observed. The improved lung function obtained with BLVR allowed nonsurgical candidates to undergo lung resection for lung cancer.

摘要翻译： 

支气管镜肺减容术（BLVR）是一种针对肺气肿的微创治疗方法。由于共同的风险因素，肺癌可能与肺气肿相关。因此，接受BLVR治疗的患者中，发生肺癌的人数可能逐渐增加。本研究旨在评估接受BLVR治疗的患者因非小细胞肺癌进行肺切除术的效果。我们回顾性分析了接受BLVR治疗后因非小细胞肺癌进行肺切除术患者的临床资料。记录每位患者的手术和肿瘤学结果，以评估该策略的效果。本研究共纳入8例患者。除一例外，所有患者的肺气肿均局限于上叶；肿瘤在BLVR术后常规随访中被发现，且未累及治疗肺叶。BLVR术前术后数据比较显示，FEV1（29.7 ± 4.9 vs. 33.7 ± 6.7，p=0.01）、FVC（28.5 ± 6.6 vs. 32.4 ± 6.1，p=0.01）、DLCO（31.5 ± 4.9 vs. 38.7 ± 5.7，p=0.02）和6MWT（237 ± 14米 vs. 271 ± 15米，p=0.01）均有显著改善，而RV（198 ± 11 vs. 143 ± 9.8，p=0.01）显著降低。肺癌手术切除方式包括楔形切除术（6例）、肺叶切除术（1例）和肺段切除术（1例）。未观察到重大并发症，术前术后数据比较显示FEV1%（33.7 ± 6.7 vs. 31.5 ± 5.3；p=0.15）和DLCO（38.7 ± 5.7 vs. 36.1 ± 5.4；p=0.15）均无显著下降。中位生存期为35个月，未观察到癌症复发。BLVR带来的肺功能改善使原本不适合手术的患者能够接受肺癌肺切除术。

原文链接：

Lung Resection for Non-Small Cell Lung Cancer following Bronchoscopic Lung Volume Reduction for Heterogenous Emphysema