含梭形/巨细胞成分肺癌17例临床病理分析  

Clinicopathologic Features of Lung Pleomorphic (Spindle/Giant Cell) Carcinoma—A Report of 17 Cases

作　　者：赵志龙[1] 宋娜[2] 黄青远[1] 刘云鹏[2] 赵惠儒[1] 

机构地区：[1]中国医科大学附属第一医院胸外科,辽宁沈阳110001 [2]中国医科大学附属第一医院肿瘤内科,辽宁沈阳110001

出　　处：《癌症》2007年第2期183-188,共6页Chinese Journal of Cancer

摘　　要：背景与目的:含梭形/巨细胞成分肺癌(carcinoma with spindle/giantcells,LCSG)是一种少见的恶性上皮肿瘤,相关文献报道较少。本研究目的是探讨LCSG临床病理特点及预后。方法:总结、分析17例手术治疗的LCSG患者的临床和组织病理学资料,并与同期手术的肺癌患者进行比较。利用生存曲线进行生存分析,Cox风险比例模型分析影响预后的独立因素。结果:LCSG患者男女比例为15∶2,年龄45～78岁,中位年龄58岁;pTNM分期Ⅰ期5例,Ⅱ期3例,Ⅲ期9例;病理类型梭形细胞癌2例,含梭形细胞癌(均伴一种恶性上皮成分,鳞癌3例、腺癌和大细胞癌各1例)5例,含巨细胞癌(分别有5例伴一种上皮癌、5例伴两种上皮癌)10例;4例Ⅰ期患者术后无瘤生存5年以上;LCSG患者比同期鳞癌的预后差(中位生存36个月和61个月,P=0.027),含巨细胞肺癌患者的预后比含梭形细胞肺癌(包括梭形细胞癌)患者差(中位生存18个月和64个月,P=0.026)。多因素分析显示淋巴结分期和含巨细胞癌是影响LCSG患者预后的危险因素。结论:LCSG作为一种独特类型的肺癌,其中含巨细胞的肺癌成分复杂,预后较差。BACKGROUND ＆ OBJECTIVE. Lung pleomorphic （spindle/ giant cell） carcinoma is a rare epithelial malignant tumor. This study was to investigate its clinicopathologic and prognostic characteristics. METHODS. Clinicopathologic records of 17 patients with lung pleomorphic （spindle/giant cell） carcinoma were reviewed and compared with those of the patients with other histopathologic types of lung cancer treated in the same period. All patients underwent surgical resection, Kaplan-Meier method was used for survival analysis. Cox proportional hazards model was used for prognostic analysis. RESULTS; The 17 patients consisted of 15 men and 2 women with median age of 58 （45-78）; 5 at stage Ⅰ , 3atstage Ⅱ , and 9atstage Ⅲ by pathologic TNM staging. Of the 17 cases of lung pleomorphic （spindle/ giant cell） carcinoma, 2 were lung exclusive spindle cell carcinoma, 5 were lung carcinoma with spindle cells （combined with one kind of epithelial components, such as squamous cell carcinoma in 3 cases, adenocarcinoma in 1 case, and large cell carcinoma in 1 case）, 10 were lung carcinoma with giant cell carcinoma （combined with one kind of epithelial components in 5 cases, two kinds in another 5 cases）. Four patients at stage Ⅰ survived free of tumor for more than 5 years. The median survival time was significantly shorter in lung pleomorphic （spindle/giant cell） carcinoma patients than in lung squamous cell carcinoma patients （36 months vs. 61 months, P=0.027）, and was also significantly longer in patients with carcinoma containing spindle cells （including spindle cell carcinoma） than in patients with carcinoma containing giant cells （64 months vs. 18 months,P= 0.026）. Lymph node metastasis and carcinoma containing giant cells were poor prognostic factors of lung pleomorphic （spindle/giant cell） carcinoma. CONCLUSION. Lung carcinoma containing giant cells has multiple cells components, and has worse prognosis than lung carcinoma containing spindle cells and spindle cells carcinoma

关 键 词：肺肿瘤 肺癌 梭形细胞 肺癌 巨细胞 肉瘤样癌 多形性癌 病理学 

分 类 号：R734.2[医药卫生—肿瘤]