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中华临床医师杂志(电子版)

中华临床医师杂志(电子版) ›› 2018, Vol. 12 ›› Issue (02) : 90 -94. doi: 10.3877/cma.j.issn.1674-0785.2018.02.006

所属专题： 文献；

临床研究

15例肺梭形细胞癌患者的临床特征及预后
邵志鹏1, 赵松1,†(), 张仁锋1, 魏创业1, 龙勇1   
  1. 1. 450052　郑州大学第一附属医院胸外一科，郑州市胸部肿瘤重点实验室
  • 收稿日期:2017-08-21 出版日期:2018-01-15
  • 通信作者: 赵松

Clinical characteristics and prognosis of fifteen cases of spindle cell carcinoma of the lung

Zhipeng Shao1, Song Zhao1,†(), Renfeng Zhang1, Chuangye Wei1, Yong Long1   

  1. 1. Department of Thoracic Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou Key Laboratory of Thoracic Oncology, Zhengzhou 450052, China
  • Received:2017-08-21 Published:2018-01-15
  • Corresponding author: Song Zhao
  • About author:
    Corresponding author: Zhao Song, Email:
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邵志鹏, 赵松, 张仁锋, 魏创业, 龙勇. 15例肺梭形细胞癌患者的临床特征及预后[J]. 中华临床医师杂志(电子版), 2018, 12(02): 90-94.

Zhipeng Shao, Song Zhao, Renfeng Zhang, Chuangye Wei, Yong Long. Clinical characteristics and prognosis of fifteen cases of spindle cell carcinoma of the lung[J]. Chinese Journal of Clinicians(Electronic Edition), 2018, 12(02): 90-94.

目的

探讨肺梭形细胞癌的临床病理特征及预后。

方法

收集2012年1月至2014年12月郑州大学第一附属医院确诊的15例肺梭形细胞癌患者的临床资料，应用Kaplan-Meier法计算生存率并绘制生存曲线。

结果

6058例肺癌患者中15例确诊为肺梭形细胞癌，其中男性12例，女性3例，中位年龄58岁，9例有大量吸烟史。CT显示肿瘤平均直径（53.6±20.3）mm，其中2例侵犯相邻结构，12例为外周型。7例患者行PET-CT，肿块平均标准摄取值为12.8±4.3，高于其他同分期的非小细胞型肺癌（NSCLC）（P=0.003）。中位生存期为12.1个月，接受外科治疗的11例患者中复发和转移较常见，手术治疗患者较非手术者生存时间更长（P=0.01），术后化疗患者较未行化疗手术患者在生存时间未能明显获益（P=0.03）。

结论

肺梭形细胞癌极为罕见，侵袭性强，易复发、转移，对化疗反应差，目前早期手术为主要治疗办法。

关键词: 肺梭形细胞癌, 临床特征, 治疗, 预后
Objective

To analyze the clinical characteristics and prognosis of spindle cell carcinoma of the lung (SpCC).

Methods

A total of 15 patients were hospitalized at our hospital between 2012 and 2014 for treatment of SpCC. We retrospectively analyzed their clinical characteristics and prognosis.

Results

Fifteen of 6058 patients with primary lung cancer were diagnosed with SpCC. Of them, twelve were male and three were female, with a median age of 58.0 years. Nine were current- or ex-smokers with substantial smoking histories. Computed tomography (CT) findings revealed that the tumors were quite large (mean diameter, 53.6±20.3 mm), with three cases having invasion of adjacent structures and 12 tumors located peripherally. Positron emission tomography-CT (PET-CT) was performed in seven patients, and the standardized uptake value (SUV) tended to be high (12.8±4.3), which was significantly higher than other NSCLC cases at the same stage (P=0.003). The median survival was 12.1 months. In 11 patients who underwent surgical treatment, recurrence and metastases frequently occurred. Patients who had undergone surgical resection survived longer than those who did not (P=0.01). Postoperative chemotherapy did not significantly prolong the survival time (P=0.03).

Conclusions

SpCC of the lung is extremely rare and has strong malignant potential with frequent recurrence and distant metastases. Response to chemotherapy is generally poor. Surgical treatment at early stage might result in better prognosis.

Key words: Spindle cell carcinoma of the lung, Clinical characteristics, Therapy, Prognosis
表1 15例梭形细胞癌患者的临床特点
例号 性别 年龄 吸烟指数 症状 肿瘤最大直径（mm） 病变部位 PET-CT标准摄取值（SUV） 临床分期 病理分期 化疗 随访时间（月）
1 男 63 60 C＋E 52 外周 10.6 T3N0M0 ⅡB T3N0M0 ⅡB 否 13.3
2 男 51 0 C＋CP 65 外周 ? T3N1M0 ⅢA T3N1M0 ⅢA 是 5.0
3 男 57 30 C＋F 41 外周 7.9 T3N1M0 ⅢA T3N1M0 ⅢA 是 10.6
4 男 46 0 C＋CD＋E 38 外周 15.6 T2aN0M0 ⅠB T2aN1M0 ⅡB 否 11.5
5 男 59 50 CD＋CP 71 外周 ? T4N0M0 ⅢA T4N1M0 ⅢA 是 15.6
6 男 59 0 H 34 外周 ? T2aN0M0 ⅠB T2aN0M0 ⅠB 否 25.4
7 男 47 20 CP 29 中央 ? T1cN0M0 ⅠA T1CN0M0 ⅠA 否 21.9
8 男 61 60 CP＋H＋F 60 外周 ? T3N0M0 ⅡB T3N1M0 ⅢA 是 2.1
9 男 62 0 -- 26 外周 ? T1bN0M0 ⅠA T1bN0M0 ⅠA 否 14.3
10 女 57 20 C＋E＋CD 61 外周 11.7 T3N0M0 ⅡB T3N1M0 ⅢA 否 8.2
11 女 51 0 C＋E 41 中央 20.0 T2bN0M0 ⅡA T2bN0M0 ⅡA 否 18.8
12 男 81 120 C＋E＋H＋F 56 外周 8.9 T3N0M0 ⅡB ? 是 10.1
13 女 67 0 CD 51 外周 ? T3N1M0 ⅢA ? 是 12.1
14 男 53 20 CD＋CP 95 外周 ? T4N2M0 ⅢB ? 是 3.7
15 男 79 50 C＋CD 83 中央 15.2 T4N1M1b ⅣA ? 是 1.8
图1 15例肺梭形细胞癌患者的总生存曲线
图2 4例行术后化疗的肺梭形细胞癌患者和7例术后未行化疗患者的生存曲线（P=0.03）
图3 11例经手术治疗的肺梭形细胞癌患者与4例未手术患者的生存曲线（P=0.01）
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