58例小细胞癌与鳞癌复合型肺癌的临床分析  

Clinical Analysis of 58 Patients with Small Cell Lung Cancer Combined with Squamous Cell Cancer

作　　者：罗扬[1] 门玉[2] 惠周光[2] 李峻岭[1] 郝学志[1] 邢镨元[1] 

机构地区：[1]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院内科,北京100021 [2]国家癌症中心/中国医学科学院北京协和医学院肿瘤医院放射治疗科,北京100021

出　　处：《中国肺癌杂志》2016年第10期659-664,共6页Chinese Journal of Lung Cancer

摘　　要：背景与目的小细胞癌与鳞癌复合型肺癌少见,本研究分析其临床病理特征和治疗现状,探讨影响预后的因素。方法回顾性分析2004年1月-2012年12月58例病理细胞学证实的小细胞癌与鳞癌复合型肺癌患者的资料,采用Kaplan-Meier法计算生存率,Log-rank法进行单因素预后分析,Cox风险回归模型分析影响总生存(overall survival,OS)的因素。结果全组患者的OS为0.3个月-124.3个月,中位OS为22.7个月。单因素分析显示:初诊卡氏评分<80分、广泛期、肿瘤-淋巴结-转移(tumor-node-metastasis,TNM)分期晚是影响OS的不良预后因素(P<0.05)。多因素分析显示,只有TNM分期是独立的影响OS的因素(P=0.019)。治疗多采取化疗为主的综合模式治疗,远处转移仍是治疗失败的主要原因。结论小细胞癌与鳞癌复合型肺癌患者的治疗多采用以化疗为主的综合治疗模式,TNM分期是独立的预后影响因素。Background and objective Small cell lung cancer combined with squamous cell carcinoma are rare. The aim of this study was to analyze the clinicopathological characteristics and treatment, and explored the prognostic factors of this disease. Methods Between January 2004 and December 2012, 58 patients with cytopathologically confirmed small cell lung cancers combined with squamous cell carcinoma were retrospectively analyzed. Kaplan-Meier methods were used to calculate the survival rate, and Log-rank test was used to examine differences between arms. The Cox regression model was used to analyze the independent factors affecting the overall survival（OS）. Results The OS of the 58 patients was 22.7 months with a range of 0.3 to 124.3 months. In univariate analysis, Karnofsky performance score before treatment, extensive disease, tumor stage were the considered prognostic factors affecting the OS rate（P0.05）. Cox multivariate analysis showed that only the tumor-node-metastasis（TNM） stage was the independent prognostic factor（P=0.019）. The majority of the patients received multimodality therapy and chemotherapy was the main treatment. Distant metastasis was the main reasonfor the treatment failure. Conclusion Combined therapy with chemotherapy as the main treatment should be adopted in therapeutic regimen of the patients with small cell lung cancers combined with squamous cell carcinoma. TNM stage was the independent prognostic factor influencing the OS.

关 键 词：肺肿瘤 小细胞癌 鳞癌 复合型癌 

分 类 号：R734.2[医药卫生—肿瘤]