肺外小细胞癌的临床特征和生存预后影响因素分析  

Extrapulmonary small cell carcinoma:Clinical and prognostic analysis

作　　者：陈一天[1] 陈龙邦[1] 王靖华[1] 褚晓源[1] 耿怀成[1] 管晓翔[1] 张群[1] 宋海珠[1] 彭玲[1] 孙茜[1] 

机构地区：[1]南京军区南京总医院肿瘤内科,南京医学硕士210002

出　　处：《医学研究生学报》2010年第11期1164-1167,共4页Journal of Medical Postgraduates

摘　　要：目的肺外小细胞癌(extrapulmonary small cell carcinoma,ESCC)发生率很低,报道较少。文中探讨ESCC的临床特征以及相关的预后因素。方法收集2001年1月至2007年6月的42例ESCC患者的临床资料,随访其生存时间,分析其临床特征治疗方法,用Kaplan-Meier法及Log-rank检验评价生存率,并用COX回归模型分析预后影响因素。结果 42例ESCC患者中病变位于食管最常见,占41%。疾病生存的影响因素为疾病TNM分期、临床分期、美国东部肿瘤协作组(eastern cooperative oncology group,ECOG)体力状况评分、病理类型。治疗相关因素分析显示综合治疗效果明显优于单用局部治疗或化疗(P<0.01)。ECOG评分(P=0.05)是影响疾病无进展生存期(progression-free survival,PFS)的独立危险因素,ECOG评分(P=0.03)、TNM分期(P=0.001)是影响疾病特异性生存期(disease-specific survival,DSS)的独立危险因素。结论 ESCC是一类可发生于人体不同部位的高度恶性肿瘤,以食管小细胞癌最多见。病变范围、体力状况评分、治疗模式是影响预后的重要因素。Objective Extrapulmonary small cell carcinoma（ESCC） has a very low incidence and is rarely reported.This study was to investigate the clinical characteristics and prognostic features of ESCC.Methods We reviewed the medical records of 42 ESCC patients,including clinical profile,treatment and disease-specific outcomes,evaluated the survival rate by Kaplan-Meier and Log-rank methods,and analyzed the influencing factors of prognosis using the univariate and multivariate COX regression model.Results The esophagus was the most frequently involved in the 42 ESCC patients（41%）.The determining factors of survival were TNM staging,clinical staging,ECOG physical scores,and pathological types.Therapeutic analysis showed current systemic treatment to be obviously superior to simple therapy（P0.01）.The ECOG score（P=0.05） was an independent risk factor for progression-free survival（PFS）,while the ECOG score（P=0.03） and TNM staging（P=0.001） were independent risk factors for disease-specific survival（DSS）.Conclusion ESCC is identified in various parts of the human body,with the esophagus most frequently involved.The clinical stage,ECOG scores and therapeutic methods are the most important prognostic factors of ESCC.

关 键 词：肺外小细胞癌 临床特征 预后 

分 类 号：R734.2[医药卫生—肿瘤]