Mansur Arian, Saleem Zain, Potter Alexandra L, Mathey-Andrews Camille, Senthil Priyanka, Yang Chi-Fu Jeffrey
Harvard Medical School, Boston, MA, USA.
University of Ottawa, Ottawa, ON, Canada.
J Thorac Dis. 2024 Sep 30;16(9):5899-5908. doi: 10.21037/jtd-24-102. Epub 2024 Sep 26.
Primary lung signet-ring cell carcinoma (LSRCC) is a rare form of aggressive lung cancer whose clinical features remain inadequately discerned. The objective of this study was to evaluate the clinicopathological characteristics and independent prognostic factors of primary LSRCC.
Overall survival (OS) of patients with LSRCC, lung adenocarcinoma (LAC), and lung mucinous adenocarcinoma (LMAC) in the National Cancer Database from 2004 to 2018 was evaluated using Kaplan-Meier and multivariable Cox proportional hazards modeling. Independent prognostic indicators for patients with LSRCC were determined using multivariable Cox proportional hazards analysis.
A total of 1,705 LSRCC, 504,006 LAC, and 15,883 LMAC patients were included in our analysis. LSRCC histology was significantly associated with younger age, male sex, larger and more poorly differentiated tumors, later American Joint Committee on Cancer (AJCC) stage disease, higher clinical T, N, and M status, more use of chemotherapy, and less use of surgery when compared to LAC and LMAC patients. In unadjusted analysis, patients with LSRCC had significantly worse OS when compared to patients with LAC and LMAC. In multivariable analysis, patients with LSRCC experienced significantly worse OS when compared to only patients with LAC. Independent predictors of survival for patients with LSRCC were younger age, later year of diagnosis, lower Charlson/Deyo comorbidity condition scores, lower AJCC stage, higher income, smaller tumors, treatment with surgery, and receipt of chemotherapy.
In this national analysis, LSRCC was found to be associated with distinct clinicopathological characteristics from those of LAC.
原发性肺印戒细胞癌（LSRCC）是侵袭性肺癌的一种罕见形式，其临床特征仍未得到充分认识。本研究的目的是评估原发性LSRCC的临床病理特征和独立预后因素。
使用Kaplan-Meier法和多变量Cox比例风险模型评估2004年至2018年国家癌症数据库中LSRCC、肺腺癌（LAC）和肺黏液腺癌（LMAC）患者的总生存期（OS）。通过多变量Cox比例风险分析确定LSRCC患者的独立预后指标。
我们的分析共纳入了1705例LSRCC患者、504,006例LAC患者和15,883例LMAC患者。与LAC和LMAC患者相比，LSRCC组织学与更年轻的年龄、男性、更大且分化程度更低的肿瘤、美国癌症联合委员会（AJCC）疾病分期更晚、更高的临床T、N和M状态、更多地使用化疗以及更少地进行手术显著相关。在未调整分析中，与LAC和LMAC患者相比，LSRCC患者的OS显著更差。在多变量分析中，与仅LAC患者相比，LSRCC患者的OS显著更差。LSRCC患者生存的独立预测因素为更年轻的年龄、更晚的诊断年份、更低的Charlson/Deyo合并症状况评分、更低的AJCC分期、更高的收入、更小的肿瘤、手术治疗以及接受化疗。
在这项全国性分析中，发现LSRCC与LAC具有不同的临床病理特征。
