文章摘要

58例肺肉瘤样癌的临床特征与预后因素

作者: 1黄韵坚, 2钟礼花, 2陈芳芳, 2陈燕坪, 1黄章洲, 2卢建平, 2王晓江, 2师怡, 2林贤东, 1庄武, 2许春伟, 2陈刚
1 福建医科大学附属福建省肿瘤医院胸部肿瘤内科，福州 350014
2 福建医科大学附属福建省肿瘤医院病理科，福州 350014
通讯: 庄武 Email: aoshitianyi@126.com
许春伟 Email: xuchunweibbb@163.com
陈刚 Email: naichengang@126.com
DOI: 10.3978/j.issn.2095-6959.2017.03.027
基金: 国家临床重点专科建设项目, 2013 福建省科技厅引导性项目, 2016Y0019 福建省科技厅引导性项目

摘要

目的：探讨肺肉瘤样癌(pulmonary sarcomatoid carcinoma，PSC)的临床特征与预后因素。方法：回顾性分析58例PSC，分别对临床特征、免疫组织化学、基因状态进行分析，Kaplan-Meier法计算生存率，Log-rank法进行生存率显著性检验，COX风险比例回归模型进行单因素和多因素分析。结果：58例PSC，以男性、<65岁和吸烟的患者为主，应用COX风险比例回归模型分析对PSC的性别、年龄、吸烟史、EGFR基因突变状态、ALK融合基因状态、分期和组织亚型进行分析，结果显示ALK融合基因状态和组织亚型是PSC独立的预后因素(P<0.05)。结论：PSC的诊断主要依靠形态和免疫组织化学，影响其预后的因素主要为ALK融合基因状态和组织亚型。
关键词： 肺肉瘤样癌 EGFR基因 ALK基因 突变率 预后

Clinical features and prognostic factors of 58 cases of pulmonary sarcomatoid carcinoma

Authors: 1HUANG Yunjian, 2ZHONG Lihua, 2CHEN Fangfang, 2CHEN Yanping, 1HUANG Zhangzhou, 2LU Jianping, 2WANG Xiaojiang, 2SHI Yi, 2LIN Xiandong, 1ZHUANG Wu, 2XU Chunwei, 2CHEN Gang
1 Department of Medical Thoracic Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou 350014, China
2 Department of Pathology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou 350014, China

CorrespondingAuthor: ZHUANG Wu Email: aoshitianyi@126.com

DOI: 10.3978/j.issn.2095-6959.2017.03.027

Abstract

Objective: To investigate the characteristics of pulmonary sarcomatoid carcinoma (PSC) and analyze the prognostic factors. Methods: Fifty-eight patients with PSC were retrospectively reviewed on the clinical data, immunohistochemistry and genetic state, and the survival rate was calculated by Kaplan-Meier method and log-rank test was used to compare the survival rates. Univariate and multivariate factors for survival were analyzed by Cox proportional hazards regression model. Results: Fifty-eight cases of PSC were men, <65 years old and smoking patients predominant; COX univariate analysis revealed that gender, age, smoking history, EGFR gene status, ALK fusion gene status, stage, histologic subtype were prognostic factors for PSC. COX multivariate analysis found that ALK fusion gene status, histologic subtype were independent prognostic factors for PSC (P<0.05). Conclusion: There is no specificity in the clinical characteristics of PSC and its successful diagnosis depends on pathological and immunohistochemical analysis. ALK fusion status and histologic subtype are the crucial prognostic factors for PSC.

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