摘要
目的分析肺大细胞神经内分泌癌(LCNEC)患者的临床病理学和胸部CT特征,以提高对该疾病的认识。方法回顾性分析2010年3月—2015年10月间在浙江大学医学院附属第一医院经病理学检查诊断为LCNEC的68例患者的临床病理学和胸部CT资料。结果68例患者中,男61例(89.7%),女7例(10.3%);年龄42~83岁,平均年龄为(64.0±7.8)岁。首次就诊时无症状28例(41.2%),咳嗽21例(30.9%),痰中带血或咯血13例(19.1%)。有吸烟史50例(73.5%),平均吸烟指数为840支年,符合重度吸烟标准。癌胚抗原(CEA)升高16例(23.5%)。表现为结节24例(35.3%),肿块44例(64.7%);肿瘤长径平均为(4.1±2.1)cm;周围型46例(67.6%);呈分叶状47例(69.1%);肿块边缘光滑或境界清楚38例(55.9%);密度均匀44例(64.7%);边缘可见毛刺20例(29.4%);侵犯临近胸膜13例(19.1%),阻塞性肺炎7例(10.3%),空洞5例(7.4%);胸腔积液、肺不张各2例(2.9%);纵隔淋巴结肿大35例(51.5%)。37例行增强CT检查的患者中,不均匀强化22例(主要为轻、中度强化)。9例(13.2%)发生远处转移。结论 LCNEC多发病于重度吸烟的老年男性,临床症状无特异性,血肿瘤标志物水平升高不常见,胸部CT表现有一定的特征性。
Objective To investigate the clinicopathological characteristics and thoracic computed tomography （CT） imaging features in patients with large cell neuroendocrine carcinoma of the lung （LCNEC）. Methods Clinical manifestations, pathological and thoracic CT features of 68 LCNEC patients were retrospectively analyzed. Results There were 61 males （89.7 % ） and 7 females （10.3 % ） with a mean age of （64.0 ± 7. 8） years （range, 42- 83 years）. No symptoms were complained in 28 cases （41. 2%）, cough happened in 21 cases （30.9%）, sputum with blood or hemoptysis in 13 cases （19. 1%） at their first visit. A history of smoking was found in 50 cases （73.5%）, and the average smoking index was 840 cigarettes per year. Carcinoembryonic antigen （CEA） was positive in 16 cases （23.5%）. Thoracic CT showed nodules in 24 cases （35.3 % ） and masses in the other 44 cases （64.7 % ）. The average diameter of the tumor was （4.1 ± 2.1 ） cm. Of them, there were 46 cases （67.6%） with peripheral lung cancer, Iobulation in 47 cases （69. 1% ）, well defined margin in 38 cases （55. 9%）, homogeneous density in 44 cases （64. 7%）, spiculated margin in 20 cases （29.4%）, the invasion approached to the pleura in 13 cases （19. 1%）, 7 cases （10. 3%） with obstructive pneumonia, 5 cases （7.4%） with cavity, 2 cases （2.9%） with pleural effusion, 2 cases （2.9%）with atelectasis, and 35 cases with mediastinal lymph node enlargement （51.5%）. Inhomogeneous enhancement （mainly mild and moderate enhancement） was found in 22 of 37 patients who underwent enhanced CT scanning. Distant metastasis occurred in 9 cases （13.2%）. Conclusion LCNEC frequently occurs in heavily smoking elderly men. It has no specific clinical features. The increase of blood tumor markers is not common, and the thoracic CT has certain characteristics.
作者
刘洋
王悦虹
阮伟良
陈胜海
李子夜
周建英
LIU Yang;WANG Yuehong;RUAN Weiliang;CHEN Shenghai;Li Ziye;ZHOU Jianying(Department of Respiratory Medicine,the First Affiliated Hospital of Zhejiang University Medical College,Hangzhou 310003,Zhejiang,China)
出处
《上海医学》
CAS
北大核心
2018年第6期339-343,共5页
Shanghai Medical Journal
关键词
肺大细胞神经内分泌癌
临床特征
胸部CT
Lung large cell neuroendocrine carcinoma
Clinical features
Thoracic computed tomography
