非小细胞肺癌皮下软组织转移临床特点及预后  

Clinical features and prognosis of non-small cell lung cancer patients with subcutaneous soft tissue metastases

作　　者：韩森[1] 聂鋆[1] 戴玲[1] 胡维亨 陈筱玲[1] 张洁[1] 马向娟[1] 田广明[1] 吴頔[1] 龙皆然[1] 韩金娣[1] 王洋[1] 张自然 方健[1] HAN Sen;NIE Jun;DAI Ling;HU Wei-heng;CHEN Xiao-ling;ZHANG Jie;MA Xiang-juan;TIAN Guang-ming;WU Di;LONG Jie-ran;HAN Jin-di;WANG Yang;ZHANG Zi-ran;FANG Jian(Department Ⅱ of Thoracic Oncology ,Key Laboratory of Carcinogenesis and Translational Research （Ministry of Education）, Peking University Cancer Hospital ＆ Institute, Beijing 100142, P. R. China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所胸部肿瘤内二科.恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《中华肿瘤防治杂志》2017年第24期1734-1737,共4页Chinese Journal of Cancer Prevention and Treatment

基　　金：北京市医院管理局临床医学发展专项经费(ZYLX201509)

摘　　要：目的晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)最常见的转移部位包括骨、脑、肾上腺和肝脏。不同的转移部位临床特点不同,预后情况也存在差异。皮下软组织转移是肺癌少见的转移类型。本研究旨在探讨NSCLC发生皮下软组织转移患者的临床特点、病理类型及预后情况。方法收集2009-09-01-2016-06-30北京大学肿瘤医院收治的NSCLC患者的病例资料,筛选其中发生皮下软组织转移的患者45例。回顾性分析45例患者的临床病例资料,总结NSCLC皮下软组织转移患者的临床特点及病理特征,通过随访了解治疗效果及生存预后情况,并进一步分析影响预后的相关因素。结果NSCLC皮下软组织转移患者的中位发病年龄为59岁。其中男30例(66.7%),女15例(33.3%)。肺癌原发灶与皮下软组织转移同时发现的为27例(60.0%),转移灶在诊治中出现的为18例(40.0%)。仅存在孤立性皮下软组织转移的为7例(15.6%),同时伴有其他远处转移的为38例(84.4%),其中伴有骨转移的33例。病理类型分别为腺癌30例(66.7%),鳞癌14例(31.1%),腺鳞癌1例(2.2%)。在26例有EGFR基因检测结果的病例中,EGFR基因突变者7例(26.9%),EGFR野生型为19例(73.1%)。45例患者的生存期为0.5~40个月,中位数为4.0个月。利用Kaplan-Meier方法计算NSCLC皮下软组织转移患者的中位生存期为4.0个月。一线治疗效果稳定的患者预后较好。结论 NSCLC患者出现皮下软组织转移提示预后极差。一线治疗效果可能是影响患者预后的独立因素。OBJECTIVE The most common metastatic sites of advanced non-small cell lung cancer include the bone,brain,adrenal gland,and liver.The clinical characteristics of different metastatic sites are different,and the prognosis is different.Subcutaneous soft tissue metastasis is a rare metastasis type of lung cancer.This study is to investigate the clinical features,pathological types and prognosis of non-small cell lung cancer patients with subcutaneous soft tissue metastases.METHODS Data of patients with NSCLC were collected from the Peking University Cancer Hospital from September 2009 to June 2016,and then the patients with subcutaneous soft tissue metastasis were enrolled.It was a retrospective analysis of 45 cases of NSCLC patients with subcutaneous soft tissue metastases.The clinical and pathological features of those patients were summarized.According to the follow-up data,understand the treatment outcome and survival prognosis,and further analysis of prognostic factors.RESULTS The median age of non-small cell lung cancer patients with subcutaneous soft tissue metastases was 59 years.There were 30 males（66.7%）and 15 females（33.3%）.Primary lung cancer and subcutaneous soft tissue metastases were found at the same time in 27 cases（60.0%）,and there were 18 cases（40.0%）in which the metastases were found afterward.Only isolated soft tissue metastases were in 7 cases（15.6%）,and 38 cases（84.4%）with other distant metastases,including 33 cases with bone metastases.Pathological types were：adenocarcinoma in 30 cases（66.7%）,squamous cell carcinoma in 14 cases（31.1%）,adeno-squamous cell carcinoma in 1 cases（2.2%）.Of the 26 patients with EGFR gene testing,7 were EGFR mutations（26.9%）and 19 were EGFR wild-type（73.1%）.The survival time of the 45 patients ranged from 0.5 months to 40 months,with a median OS of 4.0 months.Median survival time of non-small cell lung cancer patients with subcutaneous soft tissue metastases was4.0 months by Kaplan-Meier calculation.The prognosis of patien

关 键 词：肺癌 皮下软组织 转移 预后 

分 类 号：R734.2[医药卫生—肿瘤]