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41卷第6期
68例肺大细胞神经内分泌癌的临床和胸部CT特征分析
Clinical and CT features in 68 patients with large cell neuroendocrine carcinoma of the lung
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DOI:
作者:
刘洋,王悦虹,阮伟良,陈胜海,李子夜,周建英
Yang Liu ,Yue Hong Wang,Wei Liang Ruan, Sheng Hai Chen , Zi Ye Li and Jian Ying Zhou
作者单位:
刘洋:浙江大学医学院附属第一医院呼吸科(研究生在读);浙江省绍兴市柯桥区中医医院/绍兴市中西医结合医院呼吸科; 王悦虹:浙江大学医学院附属第一医院呼吸科; 阮伟良、陈胜海、李子夜:浙江省绍兴市柯桥区中医医院/绍兴市中西医结合医院呼吸科; 通讯作者:周建英:浙江大学医学院附属第一医院呼吸科;
Yang Liu:Department of Respiratory Medicine, the First Affiliated Hospital of Zhejiang University Medical College;Zhejiang shaoxing keqiao traditional Chinese medicine hospital/ shaoxing keqiao Hospital of integrated traditional Chinese and Western medicine Yue Hong Wang: Department of Respiratory Medicine, the First Affiliated Hospital of Zhejiang University Medical College Wei Liang Ruan, Sheng Hai Chen , Zi Ye Li: Department of Respiratory Medicine ,Zhejiang shaoxing keqiao traditional Chinese medicine hospital/ shaoxing keqiao Hospital of integrated traditional Chinese and Western medicine Corresponding author: Jian Ying Zhou: Department of Respiratory Medicine, the First Affiliated Hospital of Zhejiang University Medical College
关键词:
肺大细胞神经内分泌癌,临床特征,胸部CT
Lung large cell neuroendocrine carcinoma; Clinical features; Thoracic computed tomography
摘要:
【目的】探讨大细胞神经内分泌肺癌(Large-Cell Neuroendocrine Carcinoma of the Lung,LCNEC)的临床和胸部CT影像学特征,以提高对该疾病的认识。【资料与方法】回顾性分析68例肺大细胞神经内分泌癌的临床、病理和胸部CT影像资料。【结果】 68例患者中,男性61例(89.7%),女性7例(10.3%);有吸烟史50例(73.5%),中位年龄(64±7.8)岁,首诊无症状(体检)28例(41.2%),咳嗽21例(30.9%);癌胚抗原(CEA)阳性16例(23.5%);24例胸部CT表现为结节(35.3%),44例表现为肿块(64.7%),平均直径约(4.0±1.9)cm;周围型46例(67.6%),分叶47例(69.1%),密度均匀44例(64.7%),边界清楚38例(55.9%),毛刺征20例(29.4%),纵隔淋巴结肿大35例(51.5%),13例侵犯临近胸膜(19.1%),阻塞性肺炎7例(10.3%),空洞5例(7.4%),胸腔积液、肺不张各2例(2.9%),钙化0例(0%);37例行胸部CT平扫及增强扫描,其中22例呈不均匀强化(59.5%);远处转移9例(13.2%)。【结论】LCNEC多发病于重度吸烟的老年男性,临床症状无特异性;血肿瘤指标增高不常见;胸部CT表现有一定的特征性。
[Objective] To investigate the clinical characteristics and thoracic computed tomography (CT) imaging features of Large-Cell Neuroendocrine Carcinoma of the Lung (LCNEC) and to raise awareness of the disease. [Methods] Retrospectively analyzed the clinical manifestations, pathological and thoracic CT features of 68 patients with LCNEC. [Results] Of the 68 patients, 61 cases were male (89.7%), 7 cases were female (10.3%), 50 cases had a history of smoking (73.5%), and the median age was(64±7.8)years old. 28 cases (41.2%) got no symptoms; cough happened in 21 cases (30.9%). Carcinoembryonic antigen (CEA) was positive in 16 cases (23.5%);Thoracic CT showed nodules in 24 cases (35.3%) ,the other 44 cases (70.3%) showed masses, and the average diameter of the tumor was (4.0±2.1) cm. 46 cases (67.6%) developed peripheral lung cancer; lobulation 47 cases (69.1%);the density of 44 cases (64.7%) were homogeneous; well defined margin 38 cases (55.9%); spiculated margin 20 cases(29.4%),35 cases mediastinal lymph node enlargement ; 13 cases (19.1%) the invasion approached to the pleura; 7 cases (10.3%) developed obstructive pneumonia; 5 cases (7.4%) developed cavity; 2 case (2.9%) developed pleura effusion; and 2 case (2.9%) develop atelectasis,calcification 0 cases(0%).Normal chest CT and enhanced scanning of chest were administrated in 37 cases. Among them, 22 cases (59.5%) showed inhomogeneous enhancement. 9 cases distant metastasis(13.2%).[Conclusion] LCNEC frequently occur in severely smoking elderly men without specific clinical features. The increase of blood tumor markers was not common, the thoracic CT has certain characteristics.
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