37例复合型小细胞肺癌临床分析

Clinical characteristics and prognostic factors of 37 patients with combined small cell lung cancer

目的探讨复合型小细胞肺癌的临床病理特征以及预后。方法回顾性分析2016年2月至2018年12月在复旦大学附属中山医院就诊的C-SCLC患者,分析其临床病理特征及预后。结果共37例C-SCLC患者纳入研究,其中SCLC合并鳞癌患者22例(59.5%),SCLC合并腺癌患者8例(21.6%),SCLC合并大细胞癌患者7例(18.9%)。所有患者均接受至少2周期依托泊苷+铂类(EP/EC)化疗。SCLC/non-SCC的PFS有延长趋势(8.5和10个月,P=0.695)。患者的性别、是否为SCLC/SCC在PFS的差异上有统计意义(P=0.021和P=0.037)。分期在PFS上的差异可能有统计意义(P=0.052)。结论SCLC/SCC是最常见的C-SCLC类型,并且这种类型的患者的PFS比其他类型短。目前一线EP/EC方案化疗或EP/EC辅助化疗仍是C-SCLC的主要治疗方法。性别、SCLC复合病理类型是C-SCLC的独立预后因素。

Objective To evaluate the clinical and pathological characteristics of combined small cell lung cancer.Methods C-SCLC patients who received treatment from February 2016 to December 2018 in Zhongshan Hospital Affiliated to Fudan University were enrolled.Their clinical characteristics and prognosis were analyzed.Results Totally 37 patients were included,most of them were small cell combined with squamous cell carcinoma(SCLC/SCC,59.5%,N=22),then with adenocarcinoma(SCLC/ADC:21.6%,N=8),and finally with large-cell carcinoma(SCLC/LCC:18.9%,N=7).All patients received at least 2 cycles of etoposide plus platinum based(EP/EC)chemotherapy.Patients with SCLC/non-SCC had longer PFS trend(8.5 months vs 10months,P=0.695).The patients’gender and whether complicated with SCLC/SCC had statistical differences on PFS(P=0.021 and P=0.037,respectively).Different stage showed statistical difference in PFS(P=0.052).Conclusion SCLC/SCC is the most common type of C-SCLC,and patients with this type have shorter PFS than other C-SCLC.At present,first-line EP/EC chemotherapy or EP/EC adjuvant chemotherapy is still the main treatment for C-SCLC.Gender and pathological type are independent prognostic factors for C-SCLC.