Clinical Analysis Of 120 Cases Of Pulmonary Neuroendocrine Tumors

Objective:To investigate the clinicopathological features of pulmonary endocrine tumors and to analyze the relationship between clinicopathological features and prognosis.Methods: The clinical data of 120 cases were collected from December 1,2014 to January 31,2017 in Affiliated Hospital of Qinghai University and People's hospital of Qinghai,which were diagnosed by pathological report with complete medical records.Analysising the clinical data(age,sex,smokingstatus,clinicalmenifestation,histopothology and immunohistochemistrty,staging,imaging charaeristics,tumour markers,treatment)of all patients retrospectively,all patients were followed up.Count data are described by the rate or composition,rate comparison between groups using X2 test;Log-Rank method was used to analyze the single prognostic factors.The COX model was used to analyze the prognostic factors,and the Kaplan-Meier method was used to analyze the overall survival time.?=0.05.Results:1?120 cases of pulmonary neuroendocrine tumors in patients with general characteristics:male 78 cases,female 42 cases,male VS female is 1.86:1.TC 15 cases,AC 17 cases,LCNEC 10 cases,SCLC 78 cases.Age range from 30 to 82 years,median age 58 years.All of the smokers were male,smoking index > 600.8 cases have family history.48 cases with tumor diameter >3cm,72 with diameter<3cm.33 cases have No lymph node metastasis,87 cases have lymph node metastasis.2.clinical features: no specific symptoms of cough,with the highest incidence rate was 64.2%,other symptoms are common symptoms of respiratory system: typical carcinoid,atypical carcinoid,small cell lung cancer were the common symptoms of cough and sputum,chest tightness,breath etc..Some large cell neuroendocrine carcinomas are asymptomatic,and those with symptoms are also common symptoms of the respiratory system.3?Pathological features: the patients in physical examination reports there were 98 cases of tumor markers,13 tumor markers increased with NSE,Progrp increased most;91 patients underwent immunohistochemical detection and detailed results,the positive rate of 80 patients underwent Cg A testing: 37.5%.91 cases were detected by Sy N,the positive rate was 72.5%.58 cases were detected by CD56,the positive rate was 77.6%.70 cases were detected by TTF-1,the positive rate was 72.8%.4?Treatment and prognosis:50 cases received surgical treatment,97 cases received radiotherapy and chemotherapy.2 cases received palliative treatment.Univariate analysis showed that: TNM staging(P=0.009),surgery(P=0.000),chemotherapy(P=0.025)and tissue type(P=0.002)has an important impact on the survival time.Multivariate analysis showed that surgery(P=0.000),radiotherapy and chemotherapy(P=0.018),and tissue type(P=0.022)were independent prognostic factors.Conclusion:1.Gender,age and smoking status are independent of the prognosisof pulmonary neuroendocrine tumors.2.The clinical manifestations of pulmonary neuroendocrine tumors are not special,and it should be diagnosed by imaging data,tumor markers,cell morphology and immunohistochemistry.The clinical manifestations of TC,AC and SCLC were cough,sputum,chest tightness,breath and other common symptoms,many LCNEC asymptomatic.3?Surgery is one of the important therapeutic methods of TC,AC and LCNEC.Surgery is also one of the options for early stage SCLC.TC and AC with lymph node metastasis were feasible for radiotherapy and chemotherapy,and radiotherapy and chemotherapy were the first choice for SCLC,and radiotherapy and chemotherapy were also benefittto LCNEC.4.The prognosis of pulmonary neuroendocrine tumors is bad,small cell lung cancer is the worst.5,Surgery,radiotherapy andchemotherapy,tissue type are important factors of affecting prognosis.