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[肺肉瘤样癌的诊断与治疗现状]

[Current Status of Diagnosis and Treatment of Pulmonary Sarcomatoid Carcinoma].

作者信息

Liu Lei, Zang Ruochuan, Song Peng, Gao Shugeng

机构信息

Department of Thoracic Surgery, Nationanl Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, 
Chinese Academy of Medical Scienses and Peking Union Medical College, Beijing 100021, China.

出版信息

Zhongguo Fei Ai Za Zhi. 2018 Dec 20;21(12):902-906. doi: 10.3779/j.issn.1009-3419.2018.12.07.

Abstract

Pulmonary sarcomatoid carcinoma (PSC) is a rare, poorly differentiated, subtype of non-small cell lung carcinoma (NSCLC) and constitutes approximately 0.1% to 0.5% of all lung malignancies. PSC can be divided into five subtypes based on the 2015 World Health Organization (WHO) classification of lung tumors: pleomorphic carcinoma, spindle cell carcinoma, giant cell carcinoma, carcinosarcoma, and pulmonary blastoma. Some imaging characteristics can be found for PSC although no special symptoms. The accurate pathological diagnosis of PSC can be a significant challenge, which depends on pathology and immunohistochemistry. PSC should be managed similar to other NSCLC, surgical resection is the standard management for early stage cases, moreover, multimodal treatment should be considered. However, PSC is insensitive to radiotherapy and chemotherapy, and has high rate of local and metastatic recurrence and poor prognosis. With the development of molecular pathology, targeted therapy and immunotherapy may have broad prospects.
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摘要

肺肉瘤样癌(PSC)是一种罕见的、低分化的非小细胞肺癌(NSCLC)亚型,约占所有肺恶性肿瘤的0.1%至0.5%。根据2015年世界卫生组织(WHO)的肺肿瘤分类,PSC可分为五种亚型:多形性癌、梭形细胞癌、巨细胞癌、癌肉瘤和肺母细胞瘤。尽管没有特殊症状,但PSC可发现一些影像学特征。PSC的准确病理诊断可能是一项重大挑战,这取决于病理学和免疫组织化学。PSC的治疗应与其他NSCLC相似,手术切除是早期病例的标准治疗方法,此外,应考虑多模式治疗。然而,PSC对放疗和化疗不敏感,局部和转移复发率高,预后差。随着分子病理学的发展,靶向治疗和免疫治疗可能具有广阔的前景。

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