胸腺神经内分泌癌的临床特征  

Clinical features of thymic neuroendocrine carcinoma： analysis of 21 cases

作　　者：李国安[1] 柳涛[1] 蔡柏蔷[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院呼吸内科卫生部内分泌重点实验室,100730

出　　处：《中华肿瘤杂志》2012年第5期382-384,共3页Chinese Journal of Oncology

摘　　要：目的 探讨胸腺神经内分泌癌（TNC）的临床表现和治疗方法，提高对其的认识。方法回顾性分析1988年11月至2010年9月经北京协和医院收治的21例TNC患者的临床资料。结果21例TNC患者中，男12例，女9例；发病年龄13～67岁，平均年龄42岁。临床表现为胸背部不适12例（57．1％），库欣综合征7例（33．3％），1型多发性内分泌腺瘤1例（4．8％），咽部不适1例（4．8％），上腔静脉阻塞综合症1例（4．8％），无任何不适1例（4．8％）。全组有18例患者发生转移，其中淋巴结和局部血管转移13例，肺及胸膜转移9例，骨转移5例，肝转移1例。有1例患者原位复发。21例TNC患者中，手术切除20例，其中术后辅助放疗11例，术后辅助化疗9例；1例因病情严重无法手术，仅行单纯化疗。结论TNC是一种罕见肿瘤，临床表现复杂多样，恶性程度高，治疗以手术为主，出现转移可行辅助放化疗。Objective To improve the understanding of thymic neuroendocrine carcinoma （TNC） by retrospective analysis of the clinical data of 21 cases. Methods The clinical data of 21 patients with TNC treated in the Peking Union Medical College Hospital from 1998 to 2010 were retrospectively analyzed. Results There were 12 males and 9 females, with onset age ranging from 13 to 67 years and the mean age of 43 years. The clinical manifestation was diverse, in which the malaise of chest and back accounted for 57.1% （ 12/21 ） , Cushing＇s syndrome 33.3% （7/21） , multiple endocrine neoplasia type 1 accounted for 4.8% （ 1/21 ）, pharyngeal malaise 4.8%, superior vena cava syndrome 4.8% （ 1/21 ） and asymptomatic patients accounted for 4.8% （ 1/21 ）. Eighteen of them demonstrated metastasis, in which 13 had metastasis to lymph nodes and local vascular invasion, 9 to lung or pleura, 5 to bone, 1 to liver and 1 was recurred in situ. Twenty of them were treated by surgical resection. Eleven of them received radiotherapy and 9 chemotheropy after surgery. One patient was too severe to endure surgery, and was a treated by chemotherapy only. Conclusion TNC is rare, and its clinical features are complex, with a high level of malignancy. The first choice of treatment is resection. Adjuvant radiotherapy and/or chemotherapy may be applied in patients with metastasis.

关 键 词：胸腺肿瘤 癌 神经内分泌 诊断 治疗 

分 类 号：R736.3[医药卫生—肿瘤]