肺未分化大细胞癌的诊断与外科治疗预后分析(附78例)

Diagnosis and surgical treatment of undifferentiated large cell lung cancer:a report of 78 cases

目的分析肺未分化大细胞癌的临床特点、诊断、外科治疗及预后。方法回顾总结78例手术切除的肺未分化大细胞癌,全组均行手术治疗,全肺切除11例,肺叶切除57例,楔形切除6例,开胸探查行病灶或淋巴结活检4例,49例Ⅱ-Ⅳ期患者术后行化疗,分析肺未分化大细胞癌临床特点、外科治疗方法及预后情况。结果78例均有病理学诊断,其中T1N0M08例,T2N0M025例,T2N1M09例,T1N2M07例,T2N2M023例,T3N2M04例,T3N2M11例,T4N2M11例。因手术并发症死亡1例,全组中位生存期12.74个月,1、3、5年生存率分别为23.38%(18/77)、16.92%(11/65)和10.26%(4/39)。随访中全组死亡67例,死因为脑、骨、肺转移及胸膜转移。结论肺未分化大细胞癌病程短、进展快,远处转移率高,预后较差,手术效果较其他类型肺癌差。

Objective To summarize the clinical characteristics, diagnosis and surgical treatment of large cell lung cancer（LCLC）. Methods The clinical characteristics, surgical treatment and prognosis were retrospectively analyzed in 78 consecutive LCLC patients undergoing surgery. Results Of 78 cases,8 were T1N0M0,25 were T2N0M0,9 were T2N1M0,7 were T1N2M0,23 were T2N2M0,4 were T3 N2 M0,1 was T3 N2 M1, and 1 was T4 N2 M1. The 1 -year, 3-year, 5-year survival rates were 23.38% （ 18/77 ） , 16.92% （ 11/65 ） and 10.26% （4/39） ,respectively,with the median survival time of 12.74 months. After followed up,67 patients died. Conclusion LCLC has high distant metastasis rate with poor prognosis. The long-term survival rate after surgery is worse than the other lung cancers.