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目的肺外小细胞癌(extrapulmonary small cell carcinoma,ESCC)发生率很低,报道较少。文中探讨ESCC的临床特征以及相关的预后因素。方法收集2001年1月至2007年6月的42例ESCC患者的临床资料,随访其生存时间,分析其临床特征治疗方法,用Kaplan-Meier法及Log-rank检验评价生存率,并用COX回归模型分析预后影响因素。结果 42例ESCC患者中病变位于食管最常见,占41%。疾病生存的影响因素为疾病TNM分期、临床分期、美国东部肿瘤协作组(eastern cooperative oncology group,ECOG)体力状况评分、病理类型。治疗相关因素分析显示综合治疗效果明显优于单用局部治疗或化疗(P<0.01)。ECOG评分(P=0.05)是影响疾病无进展生存期(progression-free survival,PFS)的独立危险因素,ECOG评分(P=0.03)、TNM分期(P=0.001)是影响疾病特异性生存期(disease-specific survival,DSS)的独立危险因素。结论 ESCC是一类可发生于人体不同部位的高度恶性肿瘤,以食管小细胞癌最多见。病变范围、体力状况评分、治疗模式是影响预后的重要因素。
The incidence of extrapulmonary small cell carcinoma (ESCC) is very low, with few reports. The article discusses the clinical features of ESCC and related prognostic factors. Methods The clinical data of 42 patients with ESCC from January 2001 to June 2007 were collected. The survival time was followed up and the clinical features were analyzed. Kaplan-Meier method and Log-rank test were used to evaluate the survival rate. COX regression model Analysis of prognostic factors. Results Among the 42 ESCC patients, the lesions were the most common in the esophagus, accounting for 41%. The influencing factors of disease survival were TNM stage of disease, clinical staging, physical status score of Eastern Cooperative Oncology Group (ECOG) and pathological type. Treatment-related factors analysis showed that the comprehensive treatment effect was significantly better than the single local treatment or chemotherapy (P <0.01). The ECOG score (P = 0.05) was an independent risk factor affecting progression-free survival (PFS). The ECOG score (P = 0.03) and TNM stage (P = 0.001) disease-specific survival (DSS) independent risk factors. Conclusion ESCC is a type of highly malignant tumor that can occur in different parts of the human body and is the most common type of esophageal small cell carcinoma. Lesion range, physical status score, treatment mode is an important factor affecting the prognosis.