Neuroendocrine neoplasms of the lung: A prognostic spectrum
Neuroendocrine neoplasms of the lung: A prognostic spectrum
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DOI：
10.1200/jco.2005.04.1202
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发表时间：
2006-01-01
影响因子：
45.3
通讯作者：
Nagai, K
中科院分区：
文献类型：
--
作者：
Asamura, H;Kameya, T;Nagai, K
目的肺神经内分泌（NE）肿瘤包括典型类癌（TC）、非典型类癌（AC）、大细胞NE癌（LCNEC）和小细胞肺癌（SCLC），其临床病理特征和恶性程度尚未确定。组织学诊断由6位专家病理学家组成的病理小组根据WHO分类确定为TIC、AC、LCNEC或SCLC，并分析其与临床病理特征的关系。18例因标本不当而被排除，病理学小组审查了其余366例肿瘤，318例患者（87.4%）诊断为NE肿瘤; 55例患者患有TIC，9例患有AC，141例患有LCNEC，113例患有SCLC。5年生存率TC为96.2%，AC为77.8%，LCNEC为40.3%，SCLC为35.7%。TIC与AC、AC与LCNEC+SCLC之间的预后差异有统计学意义，而LCNEC与SCLC之间的预后差异无统计学意义，且两者的生存曲线重叠。多因素分析表明，组织学类型、切除完整性、症状、淋巴结转移和年龄是NE肿瘤恶性程度的重要预后因素。TIC、AC、LCNEC和SCLC。LCNEC和SCLC的预后无显著差异，高级别NE组织学均提示预后不良，与其组织学类型无关。
Purpose Neuroendocrine (NE) tumors of the lung include typical carcinoid (TC), atypical carcinoid (AC), large-cell NE carcinoma (LCNEC), and small-cell lung carcinoma (SCLC), Their clinicopathologic profiles and relative grade of malignancy have not been defined,Patients and Methods From 10 Japanese institutes, 383 surgically resected pulmonary NE tumors were collected, The histologic diagnosis was determined by the consensus of a pathology panel consisting of six expert pathologists as TIC, AC, LCNEC, or SCLC on the basis of the WHO classification, and its relationship to clinicopathologic profiles was analyzed.Results Of the 383 tumors, 18 were excluded because of an improper specimen, The pathology panel reviewed the remaining 366 tumors, and a diagnosis of NE tumor was made in 318 patients (87.4%); 55 patients had TIC, nine had AC, 141 had LCNEC, and 113 had SCLC. The 5-year survival rates of patients with all stages were as follows: 96.2% for TC, 77.8% for AC, 40.3% for LCNEC, and 35.7% for SCLC. There was significant prognostic difference between TIC and AC as well as between AC and LCNEC+SCLC, However, there was no difference between LCNEC and SCLC, and their survival curves were superimposed, The multivarate analysis indicated that histologic type, completeness of resection, symptoms, nodal involvement, and age were significantly prognostic.Conclusion The grade of malignancy of NE tumors was upgraded in the following order: TIC, AC, LCNEC, and SCLC. No prognostic difference was noted between LCNEC and SCLC, The high-grade NE histology uniformly indicated poor prognosis regardless of its histologic type.