肺大细胞神经内分泌癌127例临床分析

Clinical analysis of pulmonary large cell neuroendocrine carcinoma 127 cases

目的肺大细胞神经内分泌癌是罕见的肺部恶性肿瘤,临床缺乏大样本数据,本研究探讨肺大细胞神经内分泌癌的临床特征、诊疗方法与预后影响相关因素,希望为临床诊疗提供参考。方法回顾分析127例肺大细胞神经内分泌癌的临床病例资料,对临床特征、诊疗方法及预后影响因素进行分析。结果肺大细胞神经内分泌癌多发于有大量吸烟史的老年男性,临床表现以咳嗽、胸痛、痰血多见,CT表现以周围型肿块多见,免疫组化神经内分泌标志物Syn、Cg A、CD56阳性表达率多在80.3%(102/127)、54.3%(69/127)、64.6(82/127)。单因素分析提示吸烟指数、TNM分期、治疗方法、肿瘤直径、淋巴结转移是预后的影响因素。多因素分析提示淋巴结转移、术后辅助治疗是预后的影响因素。结论肺大细胞神经内分泌癌无特异性临床表现,诊断需要病理学确诊,TNM分期、淋巴结转移及治疗方法是影响其预后的主要因素。

Objective To pulmonary large cell neuroendocrine carcinoma is a rare pulmonary malignant tumor,clinical lack of large sample data,this study to explore the clinical features of pulmonary large cell neuroendocrine carcinoma,the diagnosis and treatment method and prognosis of influence factors,hope to provide reference for clinical diagnosis and treatment. Methods Retrospective analysis of 127 cases of pulmonary large cell neuroendocrine carcinoma clinical data,the method of clinical features,diagnosis and treatment and prognostic factors were analyzed. Results Pulmonary large cell neuroendocrine carcinoma multiple in elderly men with a large number of smoking history,clinical manifestation to cough,chest pain,phlegm,blood CT manifestations in peripheral mass,immunohistochemical neuroendocrine markers Syn,CgA,CD56 positive expression rate in 80. 3%（ 102/127）,54. 3%（ 69/127） and 64. 6（ 82/127）. Single factor analysis suggest smoking index,TNM staging,treatment and prognosis of tumor size,lymph node metastasis are the influence factors. Multiple factors analysis of lymph node metastasis,postoperative adjuvant therapy is the influence factors of prognosis. Conclusion Pulmonary large cell neuroendocrine carcinoma（ no specific clinical manifestations,diagnosis requires pathology diagnosis,TNM staging,lymph node metastasis and therapy are the main factors that affect the prognosis.