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肺混合型大细胞神经内分泌癌。

Pulmonary Combined Large Cell Neuroendocrine Carcinoma.

机构信息

Zhejiang Key Laboratory of Diagnosis & Treatment Technology on Thoracic Oncology (Lung and Esophagus), Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.

Department of Thoracic Medical Oncology, Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China.

出版信息

Pathol Oncol Res. 2022 Nov 23;28:1610747. doi: 10.3389/pore.2022.1610747. eCollection 2022.

Abstract

Pulmonary combined large-cell neuroendocrine carcinoma (CLCNEC) is a rare neuroendocrine tumor pertained to lung large cell neuroendocrine carcinoma (LCNEC) with aggressive behavior and poor prognosis generally. The clinical features of CLCNEC are not specific including cough, expectoration, chest distress, chest pain, etc., which are prone to have different manifestations of the mixed components. Owing to the low incidence, there are few related small-scale retrospective studies and case reports. Currently, the treatment regimen of CLCNEC mainly refers to LCNEC that complete surgical resection is preferred in the early stage and according to previous researches, platinum-based small cell lung cancer (SCLC) standard treatment regimen showed promising results in postoperative and advanced CLCNEC as compared to that of non-small cell lung cancer (NSCLC). Adenocarcinoma-CLCNEC more likely harbor driver gene mutation, and may benefit from targeted therapy. As for immunotherapy, more clinical trial data are needed to support its benefits. This article will fill the gap and will provide new insight into the clinical characteristics, pathological diagnosis and treatment endeavors of CLCNEC.

摘要

肺混合性大细胞神经内分泌癌(CLCNEC)是一种罕见的神经内分泌肿瘤,属于肺大细胞神经内分泌癌(LCNEC),通常具有侵袭性和不良预后。CLCNEC 的临床特征不具有特异性,包括咳嗽、咳痰、胸闷、胸痛等,容易出现混合成分的不同表现。由于发病率较低,相关的小规模回顾性研究和病例报告较少。目前,CLCNEC 的治疗方案主要参照 LCNEC,早期以完全手术切除为首选,根据既往研究,铂类小细胞肺癌(SCLC)标准治疗方案在术后和晚期 CLCNEC 中的疗效优于非小细胞肺癌(NSCLC)。腺癌-CLCNEC 更可能存在驱动基因突变,可能受益于靶向治疗。至于免疫治疗,还需要更多的临床试验数据来支持其获益。本文将填补这一空白,为 CLCNEC 的临床特征、病理诊断和治疗努力提供新的见解。

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本文引用的文献

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Clinical Behavior of Combined Versus Pure High-Grade Neuroendocrine Carcinoma.联合与单纯高级别神经内分泌癌的临床行为。
Clin Lung Cancer. 2022 Jan;23(1):e9-e16.e1. doi: 10.1016/j.cllc.2021.06.010. Epub 2021 Jul 4.

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