手术切除肺神经内分泌癌的临床特征与预后因素
| 作者: |
1庄武,
2王文娴,
1黄章洲,
1黄韵坚,
3许春伟,
4方美玉,
5朱有才,
5杜杜开齐,
3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 浙江省肿瘤医院胸部肿瘤内科，杭州 310022 3 福建医科大学附属福建省肿瘤医院病理科，福州 350014 4 浙江省肿瘤医院综合肿瘤内科，杭州 310022 5 浙江省荣军医院胸部疾病诊疗中心，浙江 嘉兴 314000 |
| 通讯: |
王文娴
Email: helen-0407@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2017.08.020 |
| 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, 2015Y0011 浙江省卫生科研计划基金项目, 2013KYB051 浙江省中医药局科研基金项目, 2013ZQ005 浙江省科技厅公益类科研计划, 2015C33194 吴阶平医学基金会临床科研资金项目, 20114272111 嘉兴市科技计划项目, 2016AY23087 |
摘要
目的：探讨手术切除肺神经内分泌癌的临床特征与预后因素。方法：回顾性分析65例手术切除肺神经内分泌癌患者的临床特征、基因状态，用Kaplan-Meier方法计算生存率，其显著性检验分析用Log-rank法，单因素和多因素分析用COX风险比例回归模型。结果：65例肺神经内分泌癌患者的临床特征差异无统计学意义(P>0.05)，基因状态改变以PIK3CA基因突变为主，小细胞癌(26.7个月)、大细胞神经内分泌癌(30.4个月)和类癌中位生存时间(未达到)差异有统计学意义(P=0.039)；小细胞癌单因素分析基因类型、癌症分期，差异具有统计学意义(P<0.05)。结论：肺神经内分泌癌基因状态改变少见，以PIK3CA基因突变为主，肺神经内分泌癌分子表达谱种类丰富且不同亚型表达谱不同，类癌生存明显高于肺大细胞神经内分泌癌和小细胞癌。
关键词：
小细胞癌
大细胞神经内分泌癌
类癌
基因状态
预后
Clinical features and prognostic factors of surgical resected pulmonary neuroendocrine carcinoma
CorrespondingAuthor: WANG Wenxian Email: helen-0407@163.com
DOI: 10.3978/j.issn.2095-6959.2017.08.020
Abstract
Objective: To investigate the characteristics of surgical resected pulmonary neuroendocrine carcinoma and to analyze the prognostic factors. Methods: We retrospectively reviewed the clinical data and genetic state of 65 patients with pulmonary neuroendocrine carcinoma, 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: There was no significant difference in clinical characteristics of 65 cases of pulmonary neuroendocrine carcinoma (P>0.05); the genetic change was given priority to with PIK3CA gene mutations, the difference in the median overall survival time among small-cell cancer (26.7 months), large cell neuroendocrine carcinoma (30.4 months) and carcinoid (did not reach) was not significant (P=0.039); and the difference in the gene subtype staging was statistically significant by the single factor analysis in small-cell cancer (P<0.05). Conclusion: Pulmonary neuroendocrine carcinoma genetic change is rare, and it is given priority to with PIK3CA gene mutations, common genomic aberrations are rare for pulmonary neuroendocrine carcinoma. Molecular profiles vary widely among different subtypes of pulmonary neuroendocrine carcinoma. Carcinoid offers better survival than pulmonary large-cell neuroendocrine carcinoma and small cell lung cancer, whereas no survival difference existed between pulmonary large-cell neuroendocrine carcinoma and small cell lung cancer.
Keywords：
small cell carcinoma
large-cell neuroendocrine carcinoma
carcinoid
gene status
Prognosis