Pleomorphic Carcinoma of the Lung Clinicopathologic Characteristics of 70 Cases
Pleomorphic Carcinoma of the Lung Clinicopathologic Characteristics of 70 Cases
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DOI：
10.1097/pas.0b013e3181804302
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发表时间：
2008-11-01
影响因子：
5.6
通讯作者：
Ochiai, Atsushi
中科院分区：
文献类型：
--
作者：
Mochizuki, Takahiro;Ishii, Genichiro;Ochiai, Atsushi
肺多形性癌（PC）是罕见的，在世界卫生组织肺肿瘤的组织学分类中被归类为肺肉瘤样癌的一个亚型。本研究回顾了70例手术切除的PC的临床病理特征。男性57例，女性13例，平均年龄66岁（29 ~ 80岁）。68个肿瘤含有可识别的上皮成分，另外2个肿瘤仅由梭形细胞和巨细胞组成。34例发现全部腺癌成分，13例发现鳞状细胞癌成分，40例发现大细胞癌成分。总生存率和无病生存率分别为36.6%和40.7%，两者均显著低于其他非小细胞肺癌。将PC患者按主要上皮成分分为腺癌组、鳞状细胞癌组和大细胞癌组，3组患者的总生存率和中位生存时间差异无统计学意义。单因素分析显示，晚期（111期）、纵隔淋巴结转移、淋巴浸润和组织学诊断的大量凝血坏死（>占肿瘤的25%）预示着较差的无病生存期。多因素分析显示，单纯的大面积坏死是独立的预后因素。我们得出结论，PC应被视为一种侵袭性疾病，应常规报告大面积坏死，并将其作为临床评估的一个因素。
Pleomorphic carcinoma (PC) of the lung is rare, and it is classified as a subtype of sarcomatoid carcinoma of the lung in the World Health Organization histologic classification of lung tumors. In this Study, 70 cases Of PC surgically resected were reviewed to identify its clinicopathologic characteristics. There were 57 men and 13 women, and their mean age was 66 years (range: 29 to 80y). Sixty-eight tumors contained identifiable epithelial components, and the other 2 consisted of spindle cells and giant cells alone. Ail adenocarcinoma component was found in 34 cases, a squamous cell carcinoma component in 13, and a large cell carcinoma component in 40. The overall survival rate and disease-free Survival rate were 36.6% and 40.7%, respectively, and both rates were significantly lower than for other nonsmall cell lung carcinomas. When the PC patients were divided into 3 groups according to the predominant epithelial component, an adenocarcinoma group, squamous cell carcinoma group, and large cell carcinoma group, there were no significant differences in the overall Survival rate and median survival time between the 3 groups. Univariate analysis revealed that advanced stage (stage 111), mediastinal lymph node metastasis, lymphatic permeation, and histologically diagnosed massive coagulation necrosis ( > 25% of the tumor) predicted poorer disease-free Survival. Multivariate analysis showed that massive necrosis alone was in independent prognostic factor. We Concluded that PC should be considered as an aggressive disease and massive necrosis should be routinely reported and used as a factor in clinical assessments.