Bepler G, Neumann K, Holle R, Havemann K, Kalbfleisch H
Department of Internal Medicine, Philipps University Marburg, West Germany.
Cancer. 1989 Jul 1;64(1):74-9. doi: 10.1002/1097-0142(19890701)64:1<74::aid-cncr2820640113>3.0.co;2-q.
Histopathologic specimens from 249 patients with small cell lung cancer (SCLC) were reviewed and classified into oat cell-type, pure intermediate cell-type (excluding specimens with mixed small cell/large cell features), and small cell/large cell-type. One hundred seventy (68%) specimens displayed oat cell features (including 30 with mixed oat cell/intermediate cell features), 66 (27%) displayed intermediate cell features, and 13 (5%) displayed mixed small cell/large cell features. No differences among these subtypes were found with respect to stage of disease, sex, age, performance status, and number and distribution of metastases. Complete and partial remission rates for the oat cell-type were, respectively, 31% and 38%, for the intermediate cell-type 20% and 45%, and for the small cell/large cell-type 38% and 31%. Two-year survival rates were 7%, 11%, and 15%, respectively. These data were all statistically insignificant, and comparisons of log-rank analyses of survival curves for these SCLC subtypes also showed no statistically significant differences. We thus conclude that histologic subtypes of SCLC are not distinct entities of clinical relevance, and that prognostic as well as therapeutic decisions cannot be based on histologic subtyping.
对249例小细胞肺癌（SCLC）患者的组织病理学标本进行了回顾，并分为燕麦细胞型、纯中间细胞型（不包括具有小细胞/大细胞混合特征的标本）和小细胞/大细胞型。170例（68%）标本显示燕麦细胞特征（包括30例具有燕麦细胞/中间细胞混合特征），66例（27%）显示中间细胞特征，13例（5%）显示小细胞/大细胞混合特征。在疾病分期、性别、年龄、体能状态以及转移灶的数量和分布方面，这些亚型之间未发现差异。燕麦细胞型的完全缓解率和部分缓解率分别为31%和38%，中间细胞型为20%和45%，小细胞/大细胞型为38%和31%。两年生存率分别为7%、11%和15%。这些数据均无统计学意义，对这些SCLC亚型生存曲线的对数秩分析比较也未显示出统计学上的显著差异。因此，我们得出结论，SCLC的组织学亚型并非具有临床相关性的不同实体，预后及治疗决策不能基于组织学亚型分类。
