肺癌胰腺转移的临床特点及预后分析

Clinical Characteristics of Lung Cancer with Pancreatic Metastases

背景与目的由于缺乏特异的临床症状,70%的肺癌患者确诊时为局部晚期或晚期,多数患者伴有实性器官转移,不同部位转移患者的临床表现及预后不同。随着诊断技术的发展,肺癌伴胰腺转移似有逐渐增多趋势。本研究针对肺癌胰腺转移的临床特点、诊治、预后及生存情况进行统计分析,探讨肺癌胰腺转移的相关预后因素。方法回顾性分析1996年7月-2017年6月于北京肿瘤医院胸部肿瘤内一科就诊的35例经病理确诊的肺癌并胰腺转移或在治疗过程中出现胰腺转移的患者,其中33例有完整随访资料。结果 35例患者中,小细胞肺癌28例(80%),腺癌3例(8.6%),鳞癌4例(11.4%)。初治时即存在胰腺转移者21例(60%),14例治疗过程中出现胰腺转移(40%)。在胰腺转移灶中,胰头转移者15例(42.9%),胰腺体尾部转移者20例(57.1%),单发转移23例(65.7%),多发转移12例(34.3%)。肺癌胰腺转移患者多无明显临床症状,本组病例中,仅4例患者在病程中出现胰腺炎症状。病理类型是影响肺癌胰腺转移患者生存的独立预后因素。结论部分晚期肺癌患者可以出现胰腺转移,多见于小细胞肺癌。肺癌患者出现胰腺转移,治疗原则以全身化疗为主的综合治疗。病理类型是影响肺癌胰腺转移患者生存的独立预后因素。

Background and objective Lacking of typical symptoms, more than 70% of patients with lung cancer are diagnosed as advanced-stage disease. Patients suffer from solid organs metastasis with different clinical features and prognosis. With development of new technology, more and more lung cancer patients are diagnosed with pancreatic metastasis. The aim of this study was to investigate clinicopathologic and survival difference by retrospective analysis among lung cancer patients with pancreatic metastases. Methods Of the patients with lung cancer diagnosed by pathology and thorough staging evaluation and treated at Beijing Cancer Hospital with long follow-up during July 1996 and June 2017, 35 cases had pancreatic metastases. Results There were 28 cases diagnosed as small cell lung cancer, 3 cases diagnosed as adenocarcinoma and 4 cases diagnosed as squamous cell carcinoma. There were 15 cases with pancreatic metastases in head of pancreas and 20 cases in body and tail of pancreas, 23 cases presented with isolated metastasis and 12 cases with multiple metastases. Pathological type was prognostic factor for lung cancer patients with pancreatic metastases. Conclusion Pancreatic metastases represents an uncommon site of extrathoracic spread of disease for part of patients with advanced lung cancer. Lung cancer with pancreatic metastases should be treated by combined therapy, especially by systemic chemotherapy. Pathological type was prognostic factor for lung cancer patients with pancreatic metastases.