A Report Of25Cases Of Pulmonary Neuroendocrine Tumors

Objective:Neuroendocrine tumor of lung is a rare but special tumor with a variety of different manifescations which makes it important. This article makes a description of the neuroendocrine lung tumor in gentic characteristics, origin,clinical manifestation, lymph node transferring, imaging manifestation, tumormakers, pathological diagnosis, histology, ultrastructure,immunochemistry, treatment, prognosis,with the hope of directing meaning to the clinical work.Method:450patients with lung tumor,all seen in Shan dong provincial hospital from January1,2012to December2013, were retrospectively reviewed which includes25neroendocrine lung cancer. Of the25patients, detailed clinical analysis has been made in the aspect of general circumstances, clinical manifescations, imaging description, preoperative checking, treatment, postoperative pathologesis.Result:Of25neuroendocrine lung carcinomar, there are14small cell lung cancer,accounting for56%,lung typical tumor1, accounting for4%, lung atypical tumor is2, accounting for8%,and large cell lung cancer, accounting for32%. The mean age of the25patients with neuroendocrine tumors is62.2years,from47years to71years, including25males and1females,24patients with the habit of smoking. The final pathology shows14small cell lung cancer, averaging age61,from47to71, lung carcinoid3, averaging age61, from58to61,which include typical cancer l,accouting for33.3%. average age60, atypical cancer, accounting for66.7%, average age59.5, from58to61,large cell lung cancer8, average age64.5, from58to69.14of the patients is of the obvious manifestations, such as chest pain, cough, fever, abdominal discomfort, dysphagia, accounting for56%. paraneoplastic syndrome is14,accounting for16,2with HPO and2with neuromuscular syndrome.11is found when examination. CT shows the tumor is located on the left upper lobe2cases, the left lower lobe12cases, the right upper lobe4cases, the right lower lobe4cases, the right middle and lower lobe2cases。 The maximum diameter of the tumor is from2.7cm to5.5cm,with an average maximum diameter of3.5cm.CT data shows central neuroendocrine lung tumors are14,while peripheral11.Four cases are round or oval isolated soft tissue nodules, smouth edeges, border clear, while14of irregular shape.4cases with obstructive pneumonia atelectasis, while8with lobulated shapes. All patients underwent chest enhanced scan, with moderate or more intension(CT value increases30Hu above),with an average rise36,from25to45.There are two cases with postoperative complication pneumonia.25cases are confirmed by bronchoscopy biopsy, CT-guided pecutaneous or surgical diagnosis. The diagnosis of the12cases is clear,11cases with biopsy by bronchoscopy, CT-guided percutaneous1case. Of3cases,the preoperative and the postoperative diagnosis is in correspondence, accounting for91.7%.Of13cases,the preoperative diagnosis is not clear, accounting for52%.smallcell lung cancer6,accounting for46.3%; lung carcinoid3,accouting for23.1%; large cell lung cancer4, accounting for30.8%, The postoperative pathology shows peripheral lymph node transferring in12,accounting for57.1%.The overall total of130lymph node is dissected, average6.2,transferring30,rate23%.Surgical treatment is21,including7cases of surgeon alone,16cases of chemotherapy after surgery,2cases with neoadjuvant therapy,4cases of chemotherapy alone.21cases are with surgical treatment, lobectomy is based with2left upper lobe dissection,2left upper lober dissection and dosal segment wedge resection,6left lower lober resection,2right upper lober dissection,5right lower lober resection,2right middle and lower lober resection.4cases is of preoperative chemotherapy and17cases with postoperative treatment, of which15with postoperative chemotherapy and2with postoperative radiotherapy and chemotherapy. Of all, peripheral lymph node is dissected, The whole group of patients is without surgical and perioperative mortality. Conclusions:Neuroendocrine tumor of lung is a specific cancer with a variety of manifescations which makes it important. The clinical manifestation is of no specification, with only a few of carcinoid syndrome.Operation is the main treatment.