Clinical Report Of 42 Cases Of Pulmonary Neuroendocrine Tumors

Objective:Pulmonary neuroendocrine tumors originates in the bronchial mucosa of Kulchitzky cells,is a class of similar pathological morphology,ultra-structure,immunohistochemistry and molecular characteristics of the tumor,accounting for about 20%of all lung cancer.In recent years,morbidity and mortality have increased year by year.With the deepening of the understanding of the disease,it has become a hot topic in the field of multidisciplinary research.In this paper,the pathology,clinical manifestation,auxiliary examination,diagnostic criteria,treatment methods and prognosis of pulmonary neuroendocrine tumors were analyzed to improve the understanding and diagnosis and treatment of these diseases.Method:We performed a retrospective analysis of the clinical data of 42 patients with pulmonary neuroendocrine tumors which were treated by thoracic surgery in Shandong Provincial Hospital from January 2010 to December 2016.Result:Of the 42 patients,27 were underwent surgical treatment,18 of whom underwent lobectomy,7 underwent pneumonectomy,and 2 with pulmonary wedge resection.Among them,5 were neoadjuvant chemotherapy and 6 were underwent surgery + Adjuvant chemotherapy in 16 cases.Fifteen patients were treated with chemotherapy alone,and the regimen was EP(etoposide + cisplatin).Postoperative pathological findings:According to WHO 2004 diagnostic diagnostic criteria,small cell lung cancer in 31 cases,7 cases of large cell neuroendocrine cancer,typical carcinoid in 3 cases,atypical carcinoid in 1 case;according to 2010 AJCC seventh edition tumor TNM staging,7 patients in stage ?,11 patients in stage ?,14 patients in stage ? and 10 patients with stage ?.The group of 42 patients were followed by telephone,a total of 40 patients were followed up,lost 2 cases,follow-up time from January 2016 to December 2016.At the end of follow-up,42 patients survived the shortest 2 months,the longest 80 months,an average of 19 months.Conclusions:Pulmonary neuroendocrine tumors account for about 20%of all lung cancer,which can be divided into four subgroups:typical carcinoid(TC),atypical carcinoid(AC),large cell neuroendocrine(LCNEC)and small cell lung cancer(SCLC).The SCLC is the most common,followed by LCNEC,carcinoid is rare.Common clinical manifestations are cough,hemoptysis,obstructive pneumonia and other symptoms,while a few may be associated with paraneoplastic syndrome.Different subtypes of lung neuroendocrine tumors differ in imaging performance.Surgery is the most important means of treatment of carcinoid.The standard treatment of the limited period SCLC is early chest radiotherapy combined with EP chemotherapy and preventively use of brain irradiation.The prognosis of TC is the best,AC and LCNEC is poor and the worst is SCLC.