Background: Non-small cell lung cancer (NSCLC) with neuroendocrine differentiation (NED) was a new pathologic type and uncommon in clinics. The aim of this study is to observe the relationship between clinical pathologic characteristics, imagination, biological behavior and prognosis in NSCLC-NED.
Methods: The clinical data of 47 patients with NSCLC-NED admitted from January 2009 to November 2017 in the Fifth Medical Center of General Hospital of People's Liberation Army were collected. The demographic data and imaging characteristics were summarized. Pathological features, treatment and prognosis, analysis of the correlation between different factors and prognosis.
Results: Of the 47 patients with NSCLC-NED, the median age was 61 years (45 years-78 years), 38 males and 9 females; 37 were poorly differentiated cancer with NED, and 10 were middle differentiated cancer with NED; 2 cases of driving gene positive (1 case of EGFR sensitive mutation, 1 case of ALK fusion), objective response rate (ORR) of first-line chemotherapy was 34.5%, and median progression-free survival (PFS) was 4 months; the median overall survival (OS) was 11 months, and only 2 cases (4.2%, 2/47) of OS were over 2 years.
Conclusions: NSCLC-NED is different from simple NSCLC or pulmonary neuroendocrine tumors. Males, ≤70 years old, severely smoking, and patients with lower tumor differentiation often have NED, and most of them are stage IV. This type of patient-driven gene positive proportion is lower than the general adenocarcinoma population, less sensitive to chemotherapy, and the overall survival is shorter, indicating a poor prognosis.
【中文题目：47例非小细胞肺癌伴神经内分泌分化的 临床特点、治疗及预后】 【中文摘要：背景与目的 非小细胞肺癌（non-small cell lung cancer, NSCLC）伴神经内分泌分化（neuroendocrine differentiation, NED）是一个新的病理分类，在临床中并不常见，本文拟探讨NSCLC-NED的临床病理特征、影像学特点、治疗及预后。方法 收集解放军总医院第五医学中心2009年1月-2017年11月期间收治的47例NSCLC-NED患者的临床资料，总结其人口学资料、影像学特点、病理特征及治疗和预后，分析不同因素与预后之间的相关性。结果 47例NSCLC-NED患者中，中位年龄61岁（45岁-78岁），男性38例，女性9例；37例为低分化癌伴NED，10例为中分化癌伴NED；2例驱动基因阳性（1例为EGFR敏感突变，1例为ALK融合），一线化疗的客观有效率（objective response rate, ORR）为34.5%，中位无进展生存期（progression-free survival, PFS）为4个月；整体中位总生存期（overall survival, OS）为11个月，OS超过2年者仅2例（4.2%, 2/47）。结论 NSCLC-NED不同于单纯的NSCLC或肺神经内分泌肿瘤，男性、≤70岁、重度吸烟、肿瘤分化程度较低者较常出现NED，且发病时多为IV期。该类患者驱动基因阳性比例低于普通腺癌人群，对化疗较不敏感，总生存期偏短，提示预后较差。 】 【中文关键词：肺肿瘤；神经内分泌分化；驱动基因；预后】.
Keywords: Driver gene; Lung neoplasms; Neuroendocrine differentiation; Prognosis.