| 方秋雁,刘建红,叶晓云,童文婷.31例肺大细胞神经内分泌癌的临床分析[J].浙江中西医结合杂志,2015,25(9): |
| 31例肺大细胞神经内分泌癌的临床分析 |
| Large cell neuroendocrine carcinoma of the lung clinical diagnosis and prognosis of 31 cases |
| 投稿时间：2015-01-31 修订日期：2015-06-20 |
| DOI： |
| 中文关键词: 肺大细胞癌 神经内分泌癌 临床诊治 预后 |
| 英文关键词: |
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| 中文摘要: |
| 【】目的 探讨肺大细胞神经内分泌癌的临床特征、治疗及生存情况。方法 回顾性分析31例肺大细胞神经内分泌癌患者的诊治过程,随访其疗效及生存情况,并对预后行单因素和多因素分析。结果 31例肺大细胞神经内分泌癌患者临床表现有胸闷气促、咳嗽咳痰、咯血等；影像学提示边界不规则的结节影,多伴有坏死；支气管镜检查提示有新生物,中央型肺癌患者行气管镜检查患者均可见菜花样或息肉样新生物；共有26例患者行手术切除加或不加淋巴结清扫术(其中行根治性手术有25例,姑息手术仅1例)；31例患者的1、3、5年生存率分别为55.6%、22.5%和11.1%。单因素分析结果显示,淋巴结转移(P=0.031)、TNM分期(P=0.000)是预后的影响因素；多因素分析结果显示,淋巴结转移(P=0.042)、TNM分期(P=0.018)和治疗方法(P=0.033)是预后的影响因素。结论 肺大细胞神经内分泌癌为高度侵袭性肿瘤,易复发和转移,预后差,由于缺乏特异性的临床及影像学表现,确诊主要依靠组织病理。淋巴结转移、TNM分期和治疗方法是影响预后的重要因素。 |
| 英文摘要: |
| Objective To investigate the clinical features of pulmonary large cell neuroendocrine carcinoma, treatment and survival. Methods A retrospective analysis of 31 cases the diagnosis and treatment of pulmonary large cell neuroendocrine carcinoma patients were followed up for its efficacy and survival, and prognostic factors in univariate and multivariate analysis lines. Results Clinical manifestations of lung large cell neuroendocrine carcinoma of 31 patients had chest tightness, shortness of breath, cough, sputum, hemoptysis; radiologic prompt irregular border nodules, many accompanied by necrosis; bronchoscopy suggestive of new creatures, central underwent bronchoscopy in patients with lung cancer were seen cauliflower or polypoid neoplasms; a total of 26 patients underwent surgical resection with or without lymph node dissection (which underwent radical surgery in 25 cases, only one case of palliative surgery); 31 cases 5-year survival rate was 55.6%, 22.5% and 11.1%. Univariate analysis showed that lymph node metastasis (P = 0.031), TNM stage (P = 0.000) are prognostic factors; multivariate analysis showed that lymph node metastasis (P = 0.042), TNM stage (P = 0.018) and treatment method (P = 0.033) are prognostic factors. Conclusion lung large cell neuroendocrine carcinoma is a highly aggressive tumor, easy to relapse and metastasis, prognosis is poor, due to the lack of specific clinical and radiographic manifestations, diagnosis relies on pathology. Lymph node metastasis, TNM staging and treatment is an important prognostic factor. |
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