Clinicopathological characteristics and prognostic factors of pulmonary large cell neuroendocrine carcinoma: A large population-based analysis
Clinicopathological characteristics and prognostic factors of pulmonary large cell neuroendocrine carcinoma: A large population-based analysis
复制标题
肺大细胞神经内分泌癌的临床病理特征和预后因素：基于大人群的分析
DOI：
10.1111/1759-7714.12993
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发表时间：
2019-04-01
期刊：
影响因子：
2.9
通讯作者：
Sun, Jianguo
中科院分区：
文献类型：
--
作者：
Yang, Qiao;Xu, Zihan;Sun, Jianguo
背景本研究旨在比较肺大细胞神经内分泌癌（LCNEC）和其他非小细胞肺癌（ONSCLC）的临床病理特征、生存结局和转移模式，并确定LCNEC的预后因素。皮尔森卡方检验用于比较临床病理特征的差异。生存分析采用Kaplan-Meier法。倾向得分用于匹配和考克斯比例风险模型被用于多变量和亚组analysis.ResultsA共2368 LCNEC情况下，231 672 ONSCLC情况下确定。LCNEC发生率随时间略有增加。除婚姻状况外，LCNEC患者与ONSCLC患者的生物学特征有明显差异。生存分析显示，LCNEC的预后差于ONSCLC。多因素分析显示，女性、黑人、手术、放疗和化疗是LCNEC的保护因素。配对亚组分析进一步表明，大多数亚组因素有利于ONSCLC，尤其是早期ONSCLC。早期LCNEC患者的肺癌特异性死亡风险高于早期ONSCLC患者。此外，LCNEC和ONSCLC之间的转移模式不同。结论LCNEC与ONSCLC具有完全不同的临床病理特征和转移方式。LCNEC也有较差的生存结局，主要是因为孤立的肝转移或合并侵犯其他器官。大多数亚组因素是LCNEC的不利因素。
BackgroundThe study was conducted to compare the clinicopathological characteristics, survival outcomes, and metastatic patterns between pulmonary large cell neuroendocrine carcinoma (LCNEC) and other non-small cell lung cancer (ONSCLC), and to identify the prognostic factors of LCNEC.MethodsData of patients diagnosed with LCNEC and ONSCLC from 2004 to 2014 were obtained from the Surveillance, Epidemiology, and End Results dataset. Pearson's chi-square tests were used to compare differences in clinicopathological characteristics. The Kaplan-Meier method was used for survival analysis. A propensity score was used for matching and a Cox proportional hazards model was used for multivariate and subgroup analyses.ResultsA total of 2368 LCNEC cases and 231 672 ONSCLC cases were identified. LCNEC incidence increased slightly over time. Except for marital status, LCNEC patients had obviously different biological features to ONSCLC patients. Survival analysis showed that LCNEC had poorer outcomes than ONSCLC. Multivariate analysis revealed that female gender, black race, surgery, radiation, and chemotherapy were protective factors for LCNEC. Matched subgroup analysis further demonstrated that most subgroup factors favored ONSCLC, especially in early stage. Early-stage LCNEC patients had a higher risk of lung cancer-specific death than early-stage ONSCLC patients. Moreover, metastatic patterns were different between LCNEC and ONSCLC. LCNEC patients with isolated liver metastasis or combined invasion to other organs had poorer survival rates.ConclusionsLCNEC has totally different clinicopathological characteristics and metastatic patterns to ONSCLC. LCNEC also has poorer survival outcomes, primarily because of isolated liver metastasis or combined invasion to other organs. Most subgroup factors are adverse factors for LCNEC.