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肺多形性癌的外科治疗:60 例回顾性研究。

Surgical treatment for pulmonary pleomorphic carcinoma: A retrospective study of 60 patients.

机构信息

Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University Shanghai, China.

出版信息

Thorac Cancer. 2014 May;5(3):250-4. doi: 10.1111/1759-7714.12086. Epub 2014 Apr 22.

Abstract

BACKGROUND

Pleomorphic carcinoma is a rare epithelial malignant tumor. Because the clinical characteristics and behavior of the disease remain unclear, we investigated the clinicopathological findings and prognosis of 60 patients with pleomorphic carcinoma.

METHODS

The clinicopathological characteristics of 60 cases of pulmonary pleomorphic carcinoma identified between 1999 and 2011 were studied. Of these, 55 patients had peripheral disease and five had central disease. The tumor size in all patients was 1-9.5 cm (mean, 5.8 ± 4.5 cm), while 30 had lesions with a diameter larger than 5 cm. All patients underwent pulmonary resection.

RESULTS

There were no in-hospital deaths. The three and five year survival rates of all patients were 47.2% and 25.6%, respectively. The three and five year survival rates were 57.3% and 32.5% for N0 patients, and 25.4% and 17.1% for N1-2 patients, respectively. Overall survival was significantly different between the radical resection and incomplete resection groups. Multivariate Cox regression analyses of overall survival for all 60 patients indicated that radical resection (P= 0.041), tumor node metastasis (TNM) stage (P= 0.044), and nodal status (P= 0.029) were significant independent prognostic factors.

CONCLUSION

Pleomorphic carcinoma is a rare type of lung cancer. In our study, pleomorphic carcinoma of the lung was often found as a peripherally located large mass and was associated with a poor prognosis. Radical resection, TNM stage and nodal status were significant independent prognostic factors.

摘要

背景

多形性癌是一种罕见的上皮恶性肿瘤。由于该病的临床特征和行为仍不清楚,我们对 60 例多形性癌患者的临床病理资料和预后进行了研究。

方法

研究了 1999 年至 2011 年间诊断的 60 例肺多形性癌患者的临床病理特征。其中,55 例为周围型病变,5 例为中央型病变。所有患者肿瘤直径为 1-9.5cm(平均 5.8±4.5cm),其中 30 例病变直径大于 5cm。所有患者均行肺切除术。

结果

无院内死亡病例。所有患者的 3 年和 5 年生存率分别为 47.2%和 25.6%。N0 患者的 3 年和 5 年生存率分别为 57.3%和 32.5%,N1-2 患者的 3 年和 5 年生存率分别为 25.4%和 17.1%。根治性切除组和不完全切除组的总生存率有显著差异。对 60 例患者的总生存率进行多因素 Cox 回归分析表明,根治性切除(P=0.041)、肿瘤淋巴结转移(TNM)分期(P=0.044)和淋巴结状态(P=0.029)是独立的预后因素。

结论

多形性癌是一种罕见的肺癌类型。在我们的研究中,肺多形性癌常表现为外周大肿块,预后较差。根治性切除、TNM 分期和淋巴结状态是独立的预后因素。

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