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[肺神经内分泌肿瘤的症状与诊断]

[Symptoms and diagnostics of lung neuroendocrine tumors].

作者信息

Tamási Lilla, Müller Veronika

机构信息

Semmelweis Egyetem, Általános Orvostudományi Kar, Pulmonológiai Klinika, Budapest.

出版信息

Orv Hetil. 2011 Mar 6;152(10):366-70. doi: 10.1556/OH.2011.29041.

Abstract

Pulmonary neuroendocrine tumors comprise 20% of all lung cancers. They are separated into 4 subgroups: typical carcinoid tumor, atypical carcinoid tumor, large-cell neuroendocrine carcinoma, and small-cell lung carcinoma. The major symptoms present in 60% of patients are cough, hemoptysis, and obstructive pneumonia. They may also exhibit hormonally related symptoms e.g. carcinoid syndrome. Small cell lung cancer is the most common subgroup, with rapid progression, aggressive metastatic potential and the worst prognosis. Large cell neuroendocrine carcinoma is rare but also has a poor prognosis. Typical carcinoid may be accompanied with hormone related symptoms and has the best prognosis; atypical one on the contrary may cause lymph node and distant metastases in half of the cases. Elevated plasma levels of chromogranin-A are present in majority of pulmonary neuroendocrine tumors and act as tumor marker. The mainstay of treatment is radical surgery if possible. In locally advanced or metastatic disease combination chemotherapy and somatostatin-analogues may have beneficial effect. This review focuses on the general features, and current diagnostic options of pulmonary neuroendocrine tumors.

摘要

肺神经内分泌肿瘤占所有肺癌的20%。它们被分为4个亚组:典型类癌肿瘤、非典型类癌肿瘤、大细胞神经内分泌癌和小细胞肺癌。60%的患者出现的主要症状是咳嗽、咯血和阻塞性肺炎。它们也可能表现出与激素相关的症状,如类癌综合征。小细胞肺癌是最常见的亚组,进展迅速,具有侵袭性转移潜能,预后最差。大细胞神经内分泌癌罕见,但预后也很差。典型类癌可能伴有与激素相关的症状,预后最好;相反,非典型类癌在半数病例中可能导致淋巴结和远处转移。大多数肺神经内分泌肿瘤患者血浆嗜铬粒蛋白A水平升高,可作为肿瘤标志物。治疗的主要方法是尽可能进行根治性手术。在局部晚期或转移性疾病中,联合化疗和生长抑素类似物可能有有益效果。本综述重点关注肺神经内分泌肿瘤的一般特征和当前的诊断方法。

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