肺大细胞神经内分泌癌分子亚型和精准治疗的研究进展  

Research Progress on Molecular Subtypes and Precision Therapy of Pulmonary Large Cell Neuroendocrine Carcinoma

作　　者：冯竽超 曹晓红 Yuchao FENG;Xiaohong CAO(Shanxi Medical University,Taiyuan 030001,China;Shanxi Fenyang Hospital,Fenyang 032299,China)

机构地区：[1]山西医科大学,太原030001 [2]山西省汾阳医院,汾阳032299

出　　处：《中国肺癌杂志》2025年第2期146-154,共9页Chinese Journal of Lung Cancer

摘　　要：肺大细胞神经内分泌癌(large cell neuroendocrine carcinoma, LCNEC)是有独特特征的高级别神经内分泌肿瘤,其治疗多借鉴小细胞肺癌与非小细胞肺癌治疗方案。近年来其发病率呈上升趋势,其预后受个体、临床分期及治疗方式等多因素交互影响,异质性显著。在分子亚型的研究中依据RB1、TP53等关键基因突变划分出多个亚组,基因组亚型与生存率、化疗反应及精准治疗的疗效相关。靶向治疗挖掘出多个靶点,药物疗效不一。免疫治疗进展突出,免疫检查点抑制剂(immune checkpoint inhibitors, ICIs)单用或联合化放疗在不同分期均显成效,却存在过度增殖性疾病风险,精准预后标志物亟待挖掘。本综述针对LCNEC的分子亚型研究和靶向、免疫等精准治疗的最新研究进展进行综述,并指出未来LCNEC治疗将朝着精准化、个体化方向发展。Pulmonary large cell neuroendocrine carcinoma(LCNEC)is a high-grade neuroendocrine tumor with unique characteristics,and its treatment regimens are primarily derived from those for small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC).In recent years,the incidence rate has been on the rise,and the prognosis are affected by the interaction of multiple factors such as individual,clinical stage and treatment mode,and the heterogeneity is significant.In the study of molecular subtypes,multiple subgroups were divided according to key gene mutations such as RB1 and TP53,and genomic subtypes were associated with survival,chemotherapy response,and efficacy of precision therapy.Targeted therapy excavates multiple targets,and the efficacy of drugs is different.Immunotherapy has made remarkable progress,and immune checkpoint inhibitors(ICIs)have been effective in all stages of chemotherapy alone or in combination with chemotherapy or radiation therapy,but there is a risk of hyperprogressive diseases,and accurate prognostic markers need to be explored urgently.This review reviews the latest research progress in the study of molecular subtypes and precision therapies such as targeted therapy and immunotherapy of pulmonary LCNEC,and points out that pulmonary LCNEC treatment will develop in the di-rection of precision and individualization in the future.

关 键 词：肺肿瘤 肺大细胞神经内分泌癌 分子分型 靶向治疗 免疫治疗 精准治疗 

分 类 号：R73[医药卫生—肿瘤]