Mimae T, Yamashita M, Maeda A, Toyosaki R, Suehisa H, Komori E, Sawada S, Kurita A, Takashima S
Department of Surgery, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan.
Kyobu Geka. 2009 Jun;62(6):442-5.
Large cell neuroendocrine carcinoma (LCNEC) is a neuroendocrine tumor comprising a subgroup of large cell carcinoma and is a type of lung cancer showing a neuroendocrine characteristic similar to that of small cell lung carcinoma In our institution, we started to diagnose LCNEC by immunostaining in 2002, and we herein report 9 patients diagnosed with LCNEC from January 2002 to May 2008. The average patient age was 74.9, male/female ratio was 8/1, and all 9 patients had a smoking history. Pathological stages IA/IB/IIB/IIIA comprised 4/1/2/2, respectively. Peripherally located and lobulated tumors were noted on preoperative computed tomography (CT), and moderate uptake of fluoro-2-deoxy-D-glucose (FDG), which balanced with the size, was recognized on positron emission tomography (PET). All 9 patients underwent surgery and 7 underwent radical surgery. Postoperative adjuvant chemotherapy was performed for 4 patients. Three showed recurrence, and 2 of these 3 died of the primary disease. The remaining 7 patients have survived to date. The possibility of LCNEC must be considered when peripherally located lung cancer with lobulation is noted on CT and shows moderate uptake of FDG for its size on PET, and multimodal treatment is needed if the diagnosis is determined postoperatively.
大细胞神经内分泌癌(LCNEC)是一种神经内分泌肿瘤,属于大细胞癌的一个亚组,是一种具有与小细胞肺癌相似神经内分泌特征的肺癌类型。在我们机构,2002年开始通过免疫染色诊断LCNEC,本文报告2002年1月至2008年5月诊断为LCNEC的9例患者。患者平均年龄为74.9岁,男女比例为8/1,所有9例患者均有吸烟史。病理分期IA/IB/IIB/IIIA分别为4/1/2/2例。术前计算机断层扫描(CT)显示肿瘤位于外周且呈分叶状,正电子发射断层扫描(PET)显示氟代脱氧葡萄糖(FDG)摄取适度,与肿瘤大小相匹配。所有9例患者均接受了手术,7例接受了根治性手术。4例患者进行了术后辅助化疗。3例出现复发,其中2例死于原发性疾病。其余7例患者至今存活。当CT显示外周分叶状肺癌且PET显示FDG摄取与其大小适度时,必须考虑LCNEC的可能性,若术后确诊则需要多模式治疗。