Division of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
Clin Lung Cancer. 2013 Sep;14(5):535-40. doi: 10.1016/j.cllc.2013.04.003. Epub 2013 Jun 20.
Large cell neuroendocrine carcinoma of the lung and SCLC are collectively classified as high-grade NECs. However, there have been few reports focusing on the differences of clinicopathological prognostic factors between resectable LCNEC and SCLC.
We reviewed the clinical data of 140 patients who underwent complete resection of high grade NEC in our institute and analyzed the clinicopathological features in relation to their survival.
There were no statistically significant differences in overall and recurrence-free survival between pure and combined subtypes in either LCNEC or SCLC. In LCNEC, larger tumor diameter (P = .01), nodal metastasis (P < .01), lymphatic permeation (P < .01), and vascular invasion (P = .01) were unfavorable prognostic factors. However, in SCLC, tumor diameter and vascular invasion were not prognostic factors, but nodal metastasis (P < .01) and lymphatic permeation (P = .03) were strongly correlated with poor prognosis.
There were no apparent differences in biological behavior between pure and combined subtypes in either LCNEC or SCLC. Lymphatic involvement was an important unfavorable prognostic factor in SCLC, whereas tumor diameter, vascular invasion, and lymphatic involvement had a poor prognostic effect in LCNEC.
肺大细胞神经内分泌癌和小细胞肺癌统称为高级别神经内分泌癌。然而,目前鲜有报道聚焦于可切除的大细胞神经内分泌癌和小细胞肺癌之间临床病理预后因素的差异。
我们回顾了我院 140 例接受高级别神经内分泌癌完全切除术患者的临床资料,并分析了与生存相关的临床病理特征。
无论是在大细胞神经内分泌癌还是小细胞肺癌中,单纯型和混合型亚组之间的总生存率和无复发生存率均无统计学差异。在大细胞神经内分泌癌中,肿瘤直径较大(P =.01)、淋巴结转移(P <.01)、淋巴渗透(P <.01)和血管浸润(P =.01)是不良预后因素。然而,在小细胞肺癌中,肿瘤直径和血管浸润不是预后因素,但淋巴结转移(P <.01)和淋巴渗透(P =.03)与不良预后密切相关。
在大细胞神经内分泌癌或小细胞肺癌中,单纯型和混合型亚组之间的生物学行为没有明显差异。淋巴浸润是小细胞肺癌的一个重要不良预后因素,而肿瘤直径、血管浸润和淋巴浸润对大细胞神经内分泌癌的预后有不良影响。