支气管肺神经内分泌肿瘤的临床特征及预后分析

发布时间：2018-02-10 12:54

本文关键词： 支气管肺神经内分泌肿瘤临床特征治疗预后　出处：《大连医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：背景与目的：支气管肺神经内分泌肿瘤(bronchopulmonary neuroendocrinetumor，BP-NET)是发生于肺和支气管上皮的神经内分泌肿瘤，约占所有肺恶性肿瘤的20％。随着对疾病研究的不断深入，检查手段的不断进步,其发病率和死亡率均呈逐年上升趋势，现在多数研究者已不认为其是一种罕见病，但目前相关报道仍较少。BP-NET具有其特殊的生物学行为，共分4个亚型，分别是典型类癌(typicalcarcinoid，TC)、不典型类癌(atypicalcarcinoid，AC)、大细胞神经内分泌癌(large cellneuroendocrine carcinoma，LCNEC)和小细胞肺癌(small cell lung carcinoma，SCLC)。不同亚型BP-NET之间的临床特征、治疗方法及预后存在着显著的差异。本研究的目的在于探讨BP-NET的临床特征、治疗方法并分析影响其预后的因素。方法：回顾性分析2003年1月至2012年12月大连市第三人民医院收治的经病理证实的263例支气管肺神经内分泌肿瘤患者的临床资料，分析本组患者年龄、性别、吸烟史、遗传因素、组织学类型、TNM分期及治疗等对预后的影响。结果：263例患者l、3、5年生存率分别为62.7％、25.8％、17.1％，，典型类癌、不典型类癌、大细胞神经内分泌癌及小细胞肺癌的5年生存率分别为83.8％、41．6％、11.8％和3．4％。单因素分析结果显示，患者的性别、年龄、吸烟史和家族史及是否行放化疗均与患者的预后无明显的相关性，而组织学类型、TNM分期、手术与预后有一定的相关性。多因素回归分析显示，TNM分期、手术及放化疗是影响预后的主要独立因素。结论：目前根治性手术及放化疗仍是支气管肺神经内分泌肿瘤的主要治疗手段。影响其预后的独立因素是TNM分期、手术和放化疗。
[Abstract]:Background & objective: bronchopulmonary neuroendocrine tumor (BP-NET) is a neuroendocrine tumor occurring in the lung and bronchial epithelium, accounting for about 20% of all malignant tumors of the lung. The morbidity and mortality of BP-NET have been increasing year by year. Now most researchers do not think it is a rare disease, but there are still few reports about it. BP-NET has its special biological behavior, which is divided into four subtypes. They are typical carcinoid carcinoma, atypical carcinoid carcinoma, large cellneuroendocrine carcinoma and small cell lung carcinoma, respectively. There are significant differences in clinical features, treatment methods and prognosis between different subtypes of BP-NET. The aim of this study was to investigate the clinical features, treatment methods and prognostic factors of BP-NET. Methods: the clinical data of 263 patients with neuroendocrine and bronchopulmonary neoplasms admitted to Dalian third people's Hospital from January 2003 to December 2012 were analyzed retrospectively. The age, sex and smoking history of the patients were analyzed. Genetic factors, histological types, TNM staging and treatment were associated with prognosis. Results the 3- and 5-year survival rates were 62.7% and 25.88%, respectively. The 5-year survival rates of typical carcinoid, atypical carcinoid, large cell neuroendocrine carcinoma and small cell lung cancer were 83.8% and 3.4%, respectively. The history of smoking, family history and radiotherapy and chemotherapy were not significantly correlated with the prognosis of the patients, but the histological type of TNM staging, surgery and prognosis were related to the prognosis. Multivariate regression analysis showed that TNM staging was significant. Surgery, radiotherapy and chemotherapy are the main independent factors affecting prognosis. Conclusion: radical operation, radiotherapy and chemotherapy are still the main treatment methods for neuroendocrine tumor of bronchus and lung. The independent factors influencing the prognosis are TNM stage, operation, radiotherapy and chemotherapy.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.4

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