肺小细胞癌临床病理特征分析

Analysis of clinicopathological features of small cell lung carcinoma

目的:分析肺小细胞癌(SCLC)的临床特点和病理特点,探讨肺小细胞癌临床及病理诊断特征。方法:收集2014年1月—2018年12月遂宁市中心医院收治的肺小细胞癌患者273例,均经病理诊断为肺小细胞癌,分析总结其临床表现和病理特征。结果:273例肺小细胞癌中男223例,女50例,年龄30~86岁。肺小细胞癌临床表现早期以呼吸系统症状为主,晚期则表现为体质量下降、疼痛、淋巴结肿大、远处转移性等恶病质症状。确诊方法:纤维支气管镜下活组织检查术217例(79.49%),穿刺活组织检查术45例(16.48%),肿瘤根治切除术11例(4.03%)。肺小细胞癌病理组织学具有独特特征。273例标本中231例行免疫组织化学检测,免疫组织化学染色标记甲状腺转录因子-1(TTF-1)、嗜铬素A(CgA)、突触素(Syn)、CD56为特异且较为灵敏的检测指标,肿瘤增殖活性采用Ki-67指数表示,Ki-67指数>50%者210例,占90.91%。结论:肺小细胞癌具有较为特殊的临床病理特征,在肺癌中其恶性程度较高,临床治疗及病理诊断中需重视其特征,联合应用免疫组化标记辅助诊断,以提高诊断率,获得较好的治疗效果。

Objective:To analyze the clinical and pathological features of Small cell lung carcinoma(SCLC)and to discuss the clinical and pathological diagnostic features.Methods:Collected 273 cases of small cell carcinoma were collected and treated in Suining central hospital from January 2014 to December 2018.The patients were diagnosed by pathological diagnosis as small cell carcinoma of the lung and analyzed the clinical manifestations and summarized the pathological features.Results:All 273 cases of pulmonary small cell carcinoma,223 males and 50 females,aged 30 to 86,with average age from 30~86 years.The clinical manifestations of small cell carcinoma in lung are mainly early respiratory symptoms,while the later stage shows the symptoms of weight loss,pain,lymph node enlargement and distant metastasis.SCLC pathological histology has unique characteristics.Methods of diagnosis:fiberoptic bronchoscopy biopsy in 217 cases(79.49%),puncture biopsy in 45 cases(16.48%),radical resection in 11 cases(4.03%).Pulmonary small cell carcinoma has unique characteristics in histopathology.231 of 273 specimens in this study were examined by immunohistochemistry.Immunohistochemical staining indicated that thyroid transcription factor-1(TTF-1),pheochromaffin A(CgA),Syn(Syn)and nerve cells adhere to molecules(CD56)were specific and sensitive indicators,and Ki-67 index was used to evaluate the proliferation ability of tumor.In this study,ki-67 index>was 50%in 210 patients with lung small cell carcinoma,accounting for 90.91%.Conclusion:Small cell lung carcinoma has a special clinical pathological feature,and its malignancy is the highest in lung cancer,and its characteristics should be emphasized in clinical treatment and pathological diagnosis in order to improve the diagnosis rate and obtain better therapeutic effect.