127例支气管肺神经内分泌肿瘤的特征及预后分析

  • 摘要: 目的:支气管肺神经内分泌肿瘤包括典型类癌、 不典型类癌、 大细胞神经内分泌癌和小细胞肺癌。尽管拥有类似的组化染色特征, 但其临床特点和预后情况并不一致。本研究拟观察肺神经内分泌肿瘤的临床、 病理特征并分析影响其预后的因素。方法: 回顾性分析天津医科大学附属肿瘤医院1975年4月至2009年7月收治的127例肺神经内分泌肿瘤临床资料, 分别对性别、 年龄、 吸烟史、 肿瘤家族史、 组织学类型、 TNM分期及治疗等项目对预后的影响进行了单因素及多因素预后分析。结果: 全组患者的1、 3及5年生存率分别为80.2%、 46.9%和40.6%, 典型类癌、 不典型类癌、 小细胞肺癌及大细胞神经内分泌癌的5年生存率分别为79.3%、 41.8%、 11.4%和0。单因素分析显示, 肿瘤大小 (P=0.000)、 组织学类型 (P=0.000)、 TNM分期 (P=0.000) 和有无术后辅助放、 化疗 (P=0.000) 是影响预后的因素。多因素分析显示, TNM分期 (P=0.040) 及有无术后辅助放、 化疗(P=0.032) 是影响预后的独立因素。结论: 根治性手术是肺神经内分泌肿瘤主要治疗手段。影响其预后的独立因素是TNM分期和有无术后辅助放化疗。

     

    Abstract: Characteristics and Prognosis of 127 Cases with Bronchopulmonary Neuroendocrine TumorsCheng CHEN1, Cuicui ZHANG2, Na LI2, Ziliang JIN2, Kai LI2Correspondence to: Kai LI, E-mail: likai5@medmail.com.cnDepartment of Pulmonary Medical Oncology, Cancer Institute and Hospital of Tianjin Medical University, Tianjin 300060,ChinaAbstract Objective: Bronchopulmonary neuroendocrine tumor (BNT) includes typical carcinoid (TC), atypical carci-noid (AC), large-cell neuroendocrine carcinoma (LCNEC) and small-cell lung carcinoma (SCLC). Although sharing featuresof cytohistology and immunohistochemistry, the clinical characteristics and prognosis of these tumors vary greatly. The aimof our study was to elucidate clinicopathologic characteristics of BNT and to analyze its prognostic factors. Methods: Theclinical data of 127 patients with BNT admitted to our hospital between April 1975 and July 2009 were enrolled in the retro-spective analysis. The prognostic factors considered in the univariate and multivariate analysis included sex, age, smokinghistory, family history, histological type, TNM stage and treatment. Results: The overall 1-, 3- and 5-year survival rates forpatients with BNT were 80.2%, 46.9% and 40.6%, respectively; the 5-year survival rates for patients with TC, AC , SCLCand LCNEC were 79.3%, 41.8%, 11.4% and 0, respectively. Cox univariate analysis revealed that the tumor size ( P =0.000), histological type ( P = 0.000), TNM stage ( P = 0.000) were postoperative adjuvant radiotherapy and/or chemothera-py ( P = 0.000) were prognostic factors after surgery. Cox multivariate analysis showed that TNM stage ( P = 0.040) werepostoperative adjuvant radiotherapy and/or chemotherapy ( P = 0.032) were independent prognostic factors. Conclusion:Radical surgery remains the major therapeutic protocol for treatment of BNT. TNM staging and postoperative adjuvant ra-dio-chemotherapy are independent prognostic factors for BNTs.Keywords Bronchopulmonary neuroendocrine tumor; Clinical characteristics; Prognostic factor

     

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