Department of Medicine Oncology, The First Affiliated Hospital of Zhengzhou University, 450052 No,1 of Jianshe east Road, Zhengzhou, China.
World J Surg Oncol. 2013 Oct 2;11:252. doi: 10.1186/1477-7819-11-252.
Pulmonary sarcomatoid carcinoma is a diagnostically challenging group of tumors. It's a rare histologic subtype of non-small cell lung cancer.There are five subgroups of pulmonary sarcomatoid carcinoma, they are identified as pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, carcinosarcoma, and pulmonary blastoma. We explored the clinicopathologic features and prognostic factors of this tumor.
We analyzed retrospectively the clinicopathological data of 51 patients with pulmonary sarcomatoid carcinoma who were treated in the First Affiliated Hospital of Zhengzhou University, Henan Cancer Hospital and Henan People Hospital from January 2005 to December 2012. The correlation between prognosis and age, sex, smoking history, tumor size, TNM staging, and treatment modality was analyzed by the statistical software SPSS 17.0. The survival analysis was conducted using the Kaplan-Meier method. The factors influencing survival were analyzed using univariate (Log-rank) and multivariate (Cox) models.
The overall survival rates at 1, 2, 3 and 5 years were 45.5%, 35.8%, 28.2% and 20.1%, respectively. Cox univariate analyses revealed that age, tumor size, T stage, M stage, surgery or not, and postoperative chemotherapy or not, were prognostic factors. Cox multivariate analysis found that tumor size and M stage were independent prognostic factors for PSC.
Due to its rarity and the lack of large-scale clinical trial evidence, few studies about PSC have been reported, its clinical and pathological characteristics remain unclear, and its preoperative diagnosis and investigation of novel treatment approaches are imperative. In our study, the main factors affecting the prognosis of tumor size and M staging are the crucial prognostic factors for PSC. Surgical resection and postoperative adjuvant chemotherapy might result in better prognosis.
肺肉瘤样癌是一组具有挑战性的诊断肿瘤。它是一种罕见的非小细胞肺癌组织学亚型。肺肉瘤样癌有五个亚组，分别为多形性癌、梭形细胞癌、巨细胞癌、癌肉瘤和肺胚细胞瘤。我们探讨了这种肿瘤的临床病理特征和预后因素。
回顾性分析 2005 年 1 月至 2012 年 12 月郑州大学第一附属医院、河南省肿瘤医院和河南省人民医院收治的 51 例肺肉瘤样癌患者的临床病理资料。采用统计学软件 SPSS 17.0 分析年龄、性别、吸烟史、肿瘤大小、TNM 分期、治疗方式与预后的相关性。采用 Kaplan-Meier 法进行生存分析，单因素（Log-rank）和多因素（Cox）模型分析影响生存的因素。
患者的 1、2、3、5 年总生存率分别为 45.5%、35.8%、28.2%和 20.1%。Cox 单因素分析显示，年龄、肿瘤大小、T 分期、M 分期、手术与否、术后化疗与否是影响预后的因素。Cox 多因素分析发现肿瘤大小和 M 分期是 PSC 的独立预后因素。
由于其罕见性和缺乏大规模临床试验证据，目前关于 PSC 的研究较少，其临床病理特征尚不清楚，术前诊断和探索新的治疗方法迫在眉睫。在本研究中，影响肿瘤大小和 M 分期的主要因素是影响 PSC 预后的关键因素。手术切除和术后辅助化疗可能会带来更好的预后。
