Li Xiaoyan, Xu Huayan, Kang Xun, Zhao Jing, Lin Yi, Wang Shasha, Liu Xiaoqing
Department of Oncologic Comprehensive Therapy, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.
Department of Lung Cancer, The Fifth Medical Center, General Hospital of People's Liberation Army, Beijing 100071, China.
Zhongguo Fei Ai Za Zhi. 2019 Aug 20;22(8):507-511. doi: 10.3779/j.issn.1009-3419.2019.08.05.
Non-small cell lung cancer (NSCLC) with neuroendocrine differentiation (NED) was a new pathologic type and uncommon in clinics. The aim of this study is to observe the relationship between clinical pathologic characteristics, imagination, biological behavior and prognosis in NSCLC-NED.
The clinical data of 47 patients with NSCLC-NED admitted from January 2009 to November 2017 in the Fifth Medical Center of General Hospital of People's Liberation Army were collected. The demographic data and imaging characteristics were summarized. Pathological features, treatment and prognosis, analysis of the correlation between different factors and prognosis.
Of the 47 patients with NSCLC-NED, the median age was 61 years (45 years-78 years), 38 males and 9 females; 37 were poorly differentiated cancer with NED, and 10 were middle differentiated cancer with NED; 2 cases of driving gene positive (1 case of EGFR sensitive mutation, 1 case of ALK fusion), objective response rate (ORR) of first-line chemotherapy was 34.5%, and median progression-free survival (PFS) was 4 months; the median overall survival (OS) was 11 months, and only 2 cases (4.2%, 2/47) of OS were over 2 years.
NSCLC-NED is different from simple NSCLC or pulmonary neuroendocrine tumors. Males, ≤70 years old, severely smoking, and patients with lower tumor differentiation often have NED, and most of them are stage IV. This type of patient-driven gene positive proportion is lower than the general adenocarcinoma population, less sensitive to chemotherapy, and the overall survival is shorter, indicating a poor prognosis.
具有神经内分泌分化（NED）的非小细胞肺癌（NSCLC）是一种新的病理类型，临床少见。本研究旨在观察NSCLC-NED的临床病理特征、影像学表现、生物学行为与预后之间的关系。
收集2009年1月至2017年11月解放军总医院第五医学中心收治的47例NSCLC-NED患者的临床资料。总结人口统计学数据和影像学特征。分析病理特征、治疗及预后情况，以及不同因素与预后的相关性。
47例NSCLC-NED患者中，中位年龄61岁（45岁至78岁），男性38例，女性9例；37例为低分化癌伴NED，10例为中分化癌伴NED；2例驱动基因阳性（1例EGFR敏感突变，1例ALK融合），一线化疗客观缓解率（ORR）为34.5%，中位无进展生存期（PFS）为4个月；中位总生存期（OS）为11个月，仅2例（4.2%，2/47）OS超过2年。
NSCLC-NED不同于单纯NSCLC或肺神经内分泌肿瘤。男性、≤70岁、重度吸烟及肿瘤分化程度较低的患者常伴有NED，且多数为IV期。此类患者驱动基因阳性比例低于一般腺癌人群，对化疗不敏感，总生存期较短，提示预后较差。
