肺癌肉瘤13例临床分析

Clinical Manifestation of Thirteen Pulmonary Carcinosarcoma

目的分析肺癌肉瘤的临床表现及特点,探讨肺癌肉瘤的预后因素及治疗方式。方法对13例肺癌肉瘤患者的临床资料,采用SPSS 18.0统计学软件进行数据分析,应用Kaplan-Meier法计算其生存率(overall survival rate,OS),并进行单因素分析。结果 13例肺癌肉瘤中,癌成分为鳞癌7例、腺癌4例(其中1例合并小细胞癌)、腺鳞癌1例、未分化癌1例。淋巴结转移以癌成分为主。单因素分析结果显示,肺癌肉瘤癌成分(P=0.047)及手术方式(P=0.019)是影响其预后的因素。结论肺癌肉瘤是肺肉瘤样癌的1种亚型,包含癌成分及肉瘤成分,其中癌成分为鳞癌者预后好于非鳞癌者(P=0.047);根治性手术是治疗肺癌肉瘤的主要方法,肺癌肉瘤术后易发生远处转移,发生远处转移后采用综合治疗,有利于提高患者远期生存率。

Objective This study was to analyze the clinical features and characteristics of pulmonary carcinosarcoma,and investigate the prognostic factors and treatment of this tumor.Methods The clinical data of pulmonary carcinosarcoma were analyzed using SPSS 18.0 software.The Overall survival rates（OS） and the prognostic factors were calculated and compared with the Kaplan-Meier method and the Log-rank test.Results Among all the 13 patients included,the carcinomatous component of carcinosarcoma was different,7 were squamous cell carcinoma,4 were adenocarcinoma（one included small cell carcinoma）,1 were adenosquamous carcinoma and 1 were undifferentiated carcinoma.The carcinomatous component appears more frequently in local lymph node metastasis.In single-factor prognostic analysis,histologic pattern of the carcinomatous component（P=0.047） and the character of operation（P=0.019） were the prognostic factor.Conclusion Pulmonary carcinosarcoma is one type of pulmonary sarcomatoid carcinoma,consisting of both carcinomatous component and sarcomatous component,while the carcinomatous component with squamous cell carcinoma had a better prognosis than non-squamous carcinoma（P=0.047）.We conclude that radical resection of this tumor may achieve good prognosis.Distant metastasis was more often to appear,but comprehensive treatment was extremely needed to improve the long-time survival.