Cancer of unknown primary site
Cancer of unknown primary site
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DOI：
10.1016/s0140-6736(11)61178-1
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发表时间：
2012-04-14
期刊：
影响因子：
168.9
通讯作者：
Pentheroudakis, George
中科院分区：
文献类型：
--
作者：
Pavlidis, Nicholas;Pentheroudakis, George
原发部位不明癌（CUP）是一种公认的临床疾病，占所有恶性上皮肿瘤的3-5%。CUP的临床特征是具有早期传播的侵袭性疾病。确定原发部位的诊断方法包括详细的组织病理学检查，特异性免疫组织化学和放射学评估。基因芯片诊断具有很高的敏感性，但需要进一步的前瞻性研究来确定其临床应用是否改善了患者的预后。转移性腺癌是最常见的CUP组织病理学（80%）。CUP患者分为预后良好（20%）和预后不良（80%）的亚组。有利的亚组大多给予局部区域治疗或全身铂类化疗。缓解和生存期与相关已知原发性肿瘤患者相似。不利亚群的患者接受基于铂或紫杉烷联合方案的经验性化疗，但反应和生存率通常较差。
Cancer of unknown primary site (CUP) is a well recognised clinical disorder, accounting for 3-5% of all malignant epithelial tumours. CUP is clinically characterised as an aggressive disease with early dissemination. Diagnostic approaches to identify the primary site include detailed histopathological examination with specific immunohistochemistry and radiological assessment. Gene-profiling microarray diagnosis has high sensitivity, but further prospective study is necessary to establish whether patients' outcomes are improved by its clinical use. Metastatic adenocarcinoma is the most common CUP histopathology (80%). CUP patients are divided into subsets of favourable (20%) and unfavourable (80%) prognosis. Favourable subsets are mostly given locoregional treatment or systemic platinum-based chemotherapy. Responses and survival are similar to those of patients with relevant known primary tumours. Patients in unfavourable subsets are treated with empirical chemotherapy based on combination regimens of platinum or taxane, but responses and survival are generally poor.