16例大细胞神经内分泌肺癌临床分析  

Clinical retrospective study of 16 patients with pulmonary large cell neuroendocrine carcinoma(LCNEC)

作　　者：王子平[1] 郭继红[1] 杨娟[2] 

机构地区：[1]中国医学科学院北京协和医学院肿瘤研究所肿瘤医院内科,北京100021 [2]四川大学华西公共卫生学院流行病教研室,成都610041

出　　处：《中国肿瘤临床与康复》2011年第5期418-421,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的分析肺大细胞神经内分泌癌(LCNEC)的临床特点以及治疗和生存特征。方法回顾性分析从1999年(2010年中国医学科学院肿瘤医院16例经病理学确诊LCNEC患者的临床相关因素。结果回顾性分析从1999年至2010年中国医学科学院肿瘤医院16例经病理学确诊为LCNEC患者的临床相关因素。结果 16例患者的中位年龄为59岁(42～77岁),男女之比为15:1,所有男性患者均为重度吸烟者。ⅠB期5例、ⅡA期1例、ⅡB期1例、ⅢA期3例、ⅢB期3例、Ⅳ期3例。16例患者中,13例经手术治疗,术后多数接受了辅助化、放疗;3例仅接受非手术治疗,其中2例接受化、放疗,1例Ⅰ期患者拒绝手术,仅接受放射治疗。中位随访时间为13.7个月,患者生存时间从7～39个月。截至2010年底末次随访时,仍然有9例患者存活,只有1名患者生存时间超过5年,所以尚未获得中位生存时间。结论 LCNEC是一种高度恶性内分泌肿瘤,预后不佳。LCNEC发病率很低,故应该对其发病情况、预后以及最佳的治疗策略进行深入探讨。Objective To analyses the clinical characteristics,therapeutic modalities and prognosis of 16 consecutive patients with pulmonary large cell neuroendocrine carcinoma（LCNEC）.Methods The clinical data of 16 patients with pulmonary LCNEC confirmed by pathology were retrospectively reviewed.Results From 1999 to 2010,sixteen patients were pathological diagnosis of LCNEC;the median age of patients was 59 years ranging from 42 years to 77 years.Fifteen patients were male,and all male patients were heavy smokers.Five patient was staged as ⅠB,one as ⅡA,one as ⅡB,three as ⅢA,three as ⅢB and three as Ⅳ.Thirteen of them underwent surgical resection,and most of them,combine adjuvant chemo-radiotherapy,the remaining 3 cases were treated by non-operation setting,two advanced stage patients received chemo-radiotherapy,and one stage Ⅰ patient refused radical resection,but accepted radiotherapy alone.Median follow up was 13.7 months.Survival ranged from 7 to 39 months.There are nine cases alive up to the time of last follow-up at end of 2010,and only one patient live longer than 5 years,so,median survival time is not available.Conclusions Pulmonary LCNEC is a high-grade neuroendocrine tumor with a poor prognosis.In our patients,some have developed widespread metastatic disease with a rapidly fatal course after multimodality treatment.Due to the rarity of this tumor,the incidence,prognosis and optimal treatment remain to be determined.

关 键 词：大细胞神经内分泌癌 肺癌 

分 类 号：R734.2[医药卫生—肿瘤] R730.5[医药卫生—临床医学]