Division of Chest Surgery, Department of Surgery, Toho University School of Medicine, 6-11-1, Omorinishi, Ota-ku, Tokyo, 143-8541, Japan.
Sci Rep. 2024 Sep 11;14(1):21274. doi: 10.1038/s41598-024-72267-5.
Pulmonary high-grade neuroendocrine carcinomas (HGNECs) have poor prognoses and require multimodal treatment, and interstitial lung disease (ILD) restricts sufficient treatment of patients with lung cancer. We aimed to clarify ILD's prognostic impact on pulmonary HGNEC, which has previously gone unreported. We retrospectively analyzed 53 patients with HGNEC who underwent resections at our department between 2006 and 2021 and evaluated the clinicopathological prognostic features, including ILD. The patients' mean age was 70 years; 46 (87%) were male, and all were smokers. Large-cell neuroendocrine and small-cell lung carcinomas were diagnosed in 36 (68%) and 17 (32%) patients, respectively. The pathological stages were stage I, II, and III in 31 (58%), 11 (21%), and 11 (21%) patients, respectively. Nine patients (17%) had ILD, which was a significant overall survival prognostic factor in a multivariate Cox proportional hazards regression analysis (p = 0.048), along with lymph node metastasis (p = 0.004) and non-administration of platinum-based adjuvant chemotherapy (p = 0.003). The 5 year survival rate of the ILD patients was 0%, significantly worse than that of patients without ILD (58.7%; p = 0.003). Patients with HGNEC and ILD had a poor prognosis owing to adjuvant therapy's limited availability for recurrence and the development of acute exacerbations associated with ILD.
肺高级别神经内分泌癌（HGNEC）预后较差，需要多模式治疗，间质性肺疾病（ILD）限制了肺癌患者的充分治疗。我们旨在阐明ILD 对以前未报道过的肺 HGNEC 的预后影响。我们回顾性分析了 2006 年至 2021 年在我科接受手术的 53 例 HGNEC 患者，并评估了包括ILD 在内的临床病理预后特征。患者的平均年龄为 70 岁；46 例（87%）为男性，均为吸烟者。36 例（68%）诊断为大细胞神经内分泌癌，17 例（32%）诊断为小细胞肺癌。病理分期为Ⅰ期、Ⅱ期和Ⅲ期的患者分别为 31 例（58%）、11 例（21%）和 11 例（21%）。9 例（17%）有ILD，这是多因素 Cox 比例风险回归分析中总生存的一个显著预后因素（p=0.048），与淋巴结转移（p=0.004）和未给予铂类辅助化疗（p=0.003）有关。ILD 患者的 5 年生存率为 0%，明显低于无 ILD 患者（58.7%；p=0.003）。由于复发时辅助治疗的可用性有限，以及与 ILD 相关的急性加重的发生，HGNEC 和 ILD 患者的预后较差。
