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肺大细胞神经内分泌癌的诊断及治疗

陈野野,  刘洪生,  李单青

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文章导航 > 协和医学杂志  > 2019 >  10(4): 393-397
陈野野, 刘洪生, 李单青. 肺大细胞神经内分泌癌的诊断及治疗[J]. 协和医学杂志, 2019, 10(4): 393-397. doi: 10.3969/j.issn.1674-9081.2019.04.016
引用本文: 陈野野, 刘洪生, 李单青. 肺大细胞神经内分泌癌的诊断及治疗[J]. 协和医学杂志, 2019, 10(4): 393-397. doi: 10.3969/j.issn.1674-9081.2019.04.016
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Ye-ye CHEN, Hong-sheng LIU, Shan-qing LI. Diagnosis and Treatment of Pulmonary Large-cell Neuroendocrine Carcinoma[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(4): 393-397. doi: 10.3969/j.issn.1674-9081.2019.04.016
Citation: Ye-ye CHEN, Hong-sheng LIU, Shan-qing LI. Diagnosis and Treatment of Pulmonary Large-cell Neuroendocrine Carcinoma[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(4): 393-397. doi: 10.3969/j.issn.1674-9081.2019.04.016
shu

肺大细胞神经内分泌癌的诊断及治疗

doi: 10.3969/j.issn.1674-9081.2019.04.016

  • 中国医学科学院 北京协和医学院 北京协和医院胸外科，北京 100730

详细信息
    通讯作者:

    李单青电话：010-69152630，E-mail：pumchlsq@163.com

  • 中图分类号: R734.1

Diagnosis and Treatment of Pulmonary Large-cell Neuroendocrine Carcinoma

  • Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

More Information
    Corresponding author: LI Shan-qing Tel: 86-10-69152630, E-mail: pumchlsq@163.com

    摘要
  • 摘要: 肺大细胞神经内分泌癌(pulmonary large-cell neuroendocrine carcinoma，LCNEC)是一种罕见的肺部上皮性恶性肿瘤，1991年被首次报道，2004年病理分型正式划归支气管肺神经内分泌肿瘤。该病多见于高龄吸烟男性，临床表现无特异性，可有呼吸道相关症状，副肿瘤综合征罕见，CT常表现为外周型结节影，可有分叶、毛刺及胸膜牵拉。LCNEC恶性程度高，患者诊断时约60%~80%出现淋巴结转移，40%出现远处转移，恶性程度接近小细胞肺癌。手术联合术后辅助治疗是Ⅰ、Ⅱ、Ⅲa期患者的主要治疗手段，化疗建议PE方案(顺铂联合依托泊苷)。转移及术后复发可能是预后不良的主要原因，肿瘤驱动基因及进一步靶向药物治疗尚有待进一步研究。
    Abstract: Pulmonary large-cell neuroendocrine carcinoma (LCNEC), first reported in 1991, is a rare pulmonary epithelial malignancy. It was not until 2004 that LCNEC was officially classified pathologically as the bronchopulmonary neuroendocrine tumor. Most of the patients are elderly male smokers. Their clinical manifestations are not specific. They may have respiratory tract-related symptoms. Paraneoplastic syndrome is rare. CT usually shows peripheral nodules, including lobulation, burr, and pleural traction. LCNEC was reported as a highly aggressive malignancy, with lymph node metastasis occurring in about 60%-80% of patients and distant metastasis in about 40% of patients, similar to the degree of malignancy of small cell lung cancer. Surgery combined with postoperative adjuvant therapy is the main treatment for stage Ⅰ, Ⅱ, and Ⅲa patients. PE regimen is recommended for chemotherapy. Metastasis and recurrence may be the main causes of poor prognosis. Tumor-driven genes and targeted drug therapy need further study.
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    • 参考文献(41)
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  • 收稿日期:  2017-04-07
  • 刊出日期:  2019-07-30

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