Pulmonary large cell carcinomas with neuroendocrine features are high-grade neuroendocrine tumors
Pulmonary large cell carcinomas with neuroendocrine features are high-grade neuroendocrine tumors
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DOI：
10.1016/s0003-4975(01)03616-5
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发表时间：
2002-04-01
影响因子：
4.6
通讯作者：
Fujisawa, T
中科院分区：
文献类型：
--
作者：
Iyoda, A;Hiroshima, K;Fujisawa, T
背景1999年，世界卫生组织（WHO）将具有神经内分泌特征的大细胞癌归类为大细胞癌的变体，并将神经内分泌肺肿瘤重新分类，特别是典型和非典型类癌肿瘤。然而，迄今为止，这些类别的神经内分泌肺肿瘤之间的临床关系还没有明确的定义。本文分析了133例原发性肺癌手术切除的神经内分泌肿瘤。根据WHO分类标准，将其分为典型类癌（TC）、非典型类癌（AC）、具有神经内分泌特征的大细胞癌（LCNF）和小细胞肺癌（SCLC）。TC和AC肿瘤与吸烟无关（p < 0.001），与LCNF不同，TC和AC肿瘤见于年轻患者（p < 0.001），男性不占优势（p < 0.001）。多变量分析显示，LCNF预测的总体和无病生存率低于SCLC（总体生存率，p = 0.019，风险比，6.34;无病生存率，p = 0.007，风险比，8.19）。LCNF的病理分级与SCLC相似，应归类为高级别神经内分泌肿瘤。(C)2002年由胸外科医师协会出版。
Background. In 1999, the World Health Organization (WHO) categorized large cell carcinoma with neuroendocrine features as variants of large cell carcinoma and reclassified neuroendocrine lung tumors, especially typical and atypical carcinoid tumors. However, to date, the clinical relationship between these categories of neuroendocrine lung tumors has not been clearly defined.Methods. We analyzed 133 cases of neuroendocrine tumors from primary lung carcinoma cases surgically resected. Using electron microscopy and immunohistochemical staining, we classified these cases as typical carcinoid (TC), atypical carcinoid (AC), large cell carcinoma with neuroendocrine features (LCNF), or small cell lung carcinoma (SCLC) based upon the WHO classification.Results. TC and AC tumors were not related to smoking (p < 0.001) and, unlike LCNF, were found in younger patients (p < 0.001) without a male predominance (p < 0.001). Multivariate analysis revealed that LCNF predicted poorer overall and disease-free survivals comparable with SCLC (overall survival, p = 0.019, hazards ratio, 6.34; disease-free survival, p = 0.007, hazards ratio, 8.19).Conclusions. The prognoses of LCNF are comparable with those of SCLC, and LCNF should be classified as high-grade neuroendocrine tumors. (C) 2002 by The Society of Thoracic Surgeons.