Qian Zhe, Hu Ying, Zheng Hua, Dong Yujie, Wang Qunhui, Li Baolan
Department of General Medicine, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
Department of Pathology, Beijing Chest Hospital, Capital Medical University/Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.
Zhongguo Fei Ai Za Zhi. 2016 Feb;19(2):82-7. doi: 10.3779/j.issn.1009-3419.2016.02.05.
Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare primary malignant tumor. Due to poor understanding of its biologic behaviors, pathological features, image manifestations and clinical effects, clinical study is urgent. Analysis of clinical data of pulmonary LCNEC, in order to improve the clinical diagnosis and treatment.
Retrospective analysis of 22 pulmonary LCNEC cases of clinical features, diagnosis, treatments and prognosis.
Pulmonary large cell neuroendocrine carcinoma occurs in older men with heavy smoking history., clinical symptoms are cough, sputum, hemoptysis, and chest pain. Computed tomography (CT) features are peripheral mass mainly, accompanied by heterogeneous density and necrosis. Immunohistochemical neuroendocrine differentiation markers Syn, CgA and CD56 positive expression rates were: 72.7%, 68.2% and 68.2%, respectively. 17 patients underwent surgical treatment, 10 patients received adjuvant therapy, 5 underwent palliative chemotherapy. Univariate analysis indicated that smoking index (P=0.029), lymph node metastasis (P=0.034), tumor-node-metastasis (TNM) stage (P=0.005), treatment (P=0.047), postoperative chemotherapy (P=0.014) are prognostic factors. Multivariate analysis showed that lymph node metastasis (P=0.045) and postoperative chemotherapy (P=0.024) are prognostic factors.
Pulmonary LCNEC is lack of specific clinical symptoms, and its pathological diagnosis depends on postoperative specimens, poor efficacy of various treatments is its current situation. Lymph node metastasis and postoperative chemotherapy are important prognostic factors.
肺大细胞神经内分泌癌（LCNEC）是一种罕见的原发性恶性肿瘤。由于对其生物学行为、病理特征、影像表现及临床影响了解不足，临床研究迫在眉睫。分析肺LCNEC的临床资料，以提高临床诊断与治疗水平。
回顾性分析22例肺LCNEC患者的临床特征、诊断、治疗及预后情况。
肺大细胞神经内分泌癌好发于有重度吸烟史的老年男性，临床症状为咳嗽、咳痰、咯血及胸痛。计算机断层扫描（CT）表现以周围型肿块为主，伴有密度不均匀及坏死。免疫组化神经内分泌分化标志物Syn、CgA和CD56的阳性表达率分别为72.7%、68.2%和68.2%。17例患者接受了手术治疗，10例患者接受了辅助治疗，5例接受了姑息化疗。单因素分析表明，吸烟指数（P=0.029）、淋巴结转移（P=0.034）、肿瘤-淋巴结-转移（TNM）分期（P=0.005）、治疗方式（P=0.047）、术后化疗（P=0.014）是预后因素。多因素分析显示，淋巴结转移（P=0.045）和术后化疗（P=0.024）是预后因素。
肺LCNEC缺乏特异性临床症状，病理诊断依赖术后标本，目前各种治疗效果欠佳。淋巴结转移和术后化疗是重要的预后因素。
