Piasecka Marta, Larsson Martin, Papakokkinou Eleni, Olsson Lena, Ragnarsson Oskar
Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Front Med (Lausanne). 2022 Aug 30;9:954033. doi: 10.3389/fmed.2022.954033. eCollection 2022.
Ectopic Cushing's syndrome (ECS) is an uncommon disorder. Recently, however, a larger proportion of patients with endogenous Cushing's syndrome (CS) had ECS than has previously been reported.
The aim of this study was to determine whether ECS is an underdiagnosed disorder in patients with small-cell lung cancer (SCLC).
Medical records from consecutive patients diagnosed with SCLC at our hospital between 2013 and 2019 were reviewed ( = 213; mean age 69.5 ± 9 years; range, 36-89 years). The probability of having ECS was evaluated by review of biochemical and clinical features, including presence of recent onset diabetes mellitus, therapy resistant hypertension and/or spontaneous hypokalaemia.
Of 213 identified patients with SCLC, one (0.5%) patient had confirmed ECS, two (1%) patients had probable ECS, and twenty-three (11%) patients had possibly ECS. Patients with SCLC and possibly or probable ECS exhibited a significantly shorter survival than patients only with SCLC (8 vs. 14 months, respectively).
Our findings indicate that ECS is underdiagnosed in patients with SCLC. Given the serious consequences of untreated ECS, the low detection rate highlights the need to improve endocrine work-up of patients with SCLC who present with biochemical and clinical features associated with ECS. Prospective studies are needed to establish a reliable assessment of the incidence of ECS and to optimise early detection strategies.
异位库欣综合征（ECS）是一种罕见疾病。然而，最近内源性库欣综合征（CS）患者中ECS的比例高于既往报道。
本研究旨在确定ECS在小细胞肺癌（SCLC）患者中是否为诊断不足的疾病。
回顾性分析2013年至2019年期间在我院连续诊断为SCLC的患者的病历（n = 213；平均年龄69.5±9岁；范围36 - 89岁）。通过回顾生化和临床特征评估发生ECS的可能性，包括近期起病的糖尿病、难治性高血压和/或自发性低钾血症。
在213例确诊的SCLC患者中，1例（0.5%）确诊为ECS，2例（1%）可能为ECS，23例（11%）可能为ECS。SCLC合并可能或很可能为ECS的患者的生存期明显短于单纯SCLC患者（分别为8个月和14个月）。
我们的研究结果表明，SCLC患者中ECS诊断不足。鉴于未经治疗的ECS会产生严重后果，低检出率凸显了对出现与ECS相关生化和临床特征的SCLC患者加强内分泌检查的必要性。需要进行前瞻性研究以建立对ECS发病率的可靠评估并优化早期检测策略。
