肺大细胞神经内分泌癌22例临床分析

BACKGROUND AND OBJECTIVE: Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare primary malignant tumor. Due to poor understanding of its biologic behaviors, pathological features, image manifestations and clinical effects, clinical study is urgent. Analysis of clinical data of pulmonary LCNEC, in order to improve the clinical diagnosis and treatment. METHODS: Retrospective analysis of 22 pulmonary LCNEC cases of clinical features, diagnosis, treatments and prognosis. RESULTS: Pulmonary large cell neuroendocrine carcinoma occurs in older men with heavy smoking history., clinical symptoms are cough, sputum, hemoptysis, and chest pain. Computed tomography (CT) features are peripheral mass mainly, accompanied by heterogeneous density and necrosis. Immunohistochemical neuroendocrine differentiation markers Syn, CgA and CD56 positive expression rates were: 72.7%, 68.2% and 68.2%, respectively. 17 patients underwent surgical treatment, 10 patients received adjuvant therapy, 5 underwent palliative chemotherapy. Univariate analysis indicated that smoking index (P=0.029), lymph node metastasis (P=0.034), tumor-node-metastasis (TNM) stage (P=0.005), treatment (P=0.047), postoperative chemotherapy (P=0.014) are prognostic factors. Multivariate analysis showed that lymph node metastasis (P=0.045) and postoperative chemotherapy (P=0.024) are prognostic factors. CONCLUSION: Pulmonary LCNEC is lack of specific clinical symptoms, and its pathological diagnosis depends on postoperative specimens, poor efficacy of various treatments is its current situation. Lymph node metastasis and postoperative chemotherapy are important prognostic factors.