Analysis On The Clinical Characteristics And Prognosis Of Pulmonary Large Cell Neuroendocrine Carcinoma

BackgroundLung cancer is one of the high incidence and mortality of malignant tumor at present,the histological type of the adenocarcinoma,accounting for all of China's more than 40%cases of lung cancer^[1],large cell neuroendocrine carcinoma of the lung as a large cell lung cancer variant subtype,is a rare malignant tumor of the lung.It is difficult for clinical diagnosis and treatment during to be insidious,low incidence,high degree of malignancy and high misdiagnosis rate.WHO?World Health Organization,WHO?2015 lung cancer pathology classification of small cell lung cancer?SCLC?,Atypical carcinoid?AC?,Typical carcinoid?TC?and lung large cell neuroendocrine carcinoma?L-LCNEC?are commonly classified as of pulmonary neuroendocrine carcinoma^[2],which is also the same.It indicates a new way for the diagnosis and treatment of L-LCNEC in the future.Large cell neuroendocrine carcinoma of the lung is one of the highly malignant neuroendocrine tumor with neuroendocrine tumor differentiation and morphological characteristics of large cell lung cancer characteristics,with strong aggressive;poor curative effect through simple surgery,chemotherapy and radio-therapy treatment,Based on the currently limited public data,the clinical characteristics and treatment of L-LCNEC has been controversial.ObjectiveThe dissertation aims to provide new ideas for clinical diagnosis and treatment for L-LCNEC by carrying out a retrospective research on the clinical features,the rapeutic methods and factors which affect the prognosis of L-LCNEC.MethodsThe clinical date of 127 patients with large cell neuroendocrine carcinoma confirmed by pathology in the First Affiliated Hospital of Zhengzhou University from January 2010 to December 2015 were retrospectively analyzed.The parameters were evaluated by univariate and multivariate analysis,including the gender,age,smoking index,tumor diameter,tumor history,TNM staging,localization?central or peripheral?,tumor size,family history,tumor staging,lymph node metastasis?with or without?and treatment scheme?operative or nonoperative?ResultsLarge cell neuroendocrine lung cancer is more common in elderly men,who have a history of heavy smoking.Coughing,chest pain,bloody sputum are the main clinical manifestations.Peripheral lumps are dominated in CT scan images.The positive expression rate in immunohistochemical neuroendocrine markers for Syn,CgA and CD56 is 80.3%?102/127?,54.3%?69/127?and 64.6%?82/127?,respectively.Cox univariate analysis revealed that the smoking index,TNM staging,treatment methods,tumor diameter and lymph node metastasis?P<0.05?were the prognostic factors of the patients with large cell neuroen-docrine lung cancer,whereas its multivariate analysis confirmed that that TNM staging,lymph node metastasis,and postoperative adjuvant therapy?P<0.05?were independent factors which affected the prognosis.ConclusionsLarge cell neuroendocrine carcinoma of the lung has no specific clinical and imaging manifestations,with its final diagnosis depending on pathological confirmation.The TNM staging,lymph node metastasis and treatment are confirmed to be the independent prognostic factors in the multivariable models for Large cell neuroendocrine carcinoma.Surgery combining with chemotherapy can improve the prognosis of patients,by improving the short-term survival rate.