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临床病理因素影响手术切除的肺多形性癌的预后。

Clinicopathological factors influenced the prognosis of surgically resected pulmonary pleomorphic carcinoma.

作者信息

Okuda Katsuhiro, Oda Risa, Suzuki Ayumi, Sakane Tadashi, Kawano Osamu, Haneda Hiroshi, Moriyama Satoru, Nakanishi Ryoichi

机构信息

Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan.

出版信息

J Thorac Dis. 2017 May;9(5):1295-1302. doi: 10.21037/jtd.2017.03.167.

Abstract

BACKGROUND

Pulmonary pleomorphic carcinoma has made an unfavorable prognosis because of its properties of resisting radiation and chemotherapy, and its aggressive growth. The correlation between clinicopathological factors and prognosis about pulmonary pleomorphic carcinoma patients who received its surgical resection has not been clearly identified.

METHODS

We retrospectively investigated the clinical records of 24 pulmonary pleomorphic carcinoma patients who had a surgical resection from January 2004 to December 2013 at our institute. We examined the correlation between their clinicopathological factors and therapeutic effects including their prognosis.

RESULTS

The median follow up time was 2.3 years. The 5-year survival was 54.7% and the 5-year progression free survival was 52.4%. In comparison with other tissue types of lung cancer, the prognosis was not so poor even taking into consideration the survival curve including several progression stages. We analyzed the 21 clinicopathological factors in order to clarify the factors connected with the prognosis and disease progression. As a result, we found that both vascular invasion evaluated by immunohistochemistry and lymph node metastasis were connected closely with the overall survival. We found another strong link between the tissue type of epithelial components, vascular invasion evaluated by immunohistochemistry and lymph nodal metastasis with the progression free survival.

CONCLUSIONS

Pulmonary pleomorphic carcinoma patients with lymph node metastasis and vascular invasion had worse prognosis after their surgical resections. We have to find an effective chemotherapeutic drug or molecular targeted drug.

摘要

背景

肺多形性癌因其抗辐射和化疗的特性以及侵袭性生长,预后不佳。对于接受手术切除的肺多形性癌患者,临床病理因素与预后之间的相关性尚未明确。

方法

我们回顾性研究了2004年1月至2013年12月在我院接受手术切除的24例肺多形性癌患者的临床记录。我们研究了他们的临床病理因素与包括预后在内的治疗效果之间的相关性。

结果

中位随访时间为2.3年。5年生存率为54.7%,5年无进展生存率为52.4%。与其他组织学类型的肺癌相比,即使考虑到包括几个进展阶段的生存曲线,预后也不算太差。我们分析了21项临床病理因素,以明确与预后和疾病进展相关的因素。结果发现,免疫组化评估的血管侵犯和淋巴结转移均与总生存密切相关。我们还发现上皮成分的组织学类型、免疫组化评估的血管侵犯和淋巴结转移与无进展生存之间存在密切联系。

结论

发生淋巴结转移和血管侵犯的肺多形性癌患者手术切除后的预后较差。我们必须找到一种有效的化疗药物或分子靶向药物。

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