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目的:探讨手术切除肺神经内分泌癌的临床特征与预后因素。方法:回顾性分析65例手术切除肺神经内分泌癌患者的临床特征、基因状态,用Kaplan-Meier方法计算生存率,其显著性检验分析用Log-rank法,单因素和多因素分析用COX风险比例回归模型。结果 :65例肺神经内分泌癌患者的临床特征差异无统计学意义(P>0.05),基因状态改变以PIK3CA基因突变为主,小细胞癌(26.7个月)、大细胞神经内分泌癌(30.4个月)和类癌中位生存时间(未达到)差异有统计学意义(P=0.039);小细胞癌单因素分析基因类型、癌症分期,差异具有统计学意义(P<0.05)。结论:肺神经内分泌癌基因状态改变少见,以PIK3CA基因突变为主,肺神经内分泌癌分子表达谱种类丰富且不同亚型表达谱不同,类癌生存明显高于肺大细胞神经内分泌癌和小细胞癌。
Objective: To investigate the clinical characteristics and prognostic factors of surgical resection of pulmonary neuroendocrine carcinoma. Methods: The clinical features and gene status of 65 patients with surgical resection of pulmonary neuroendocrine carcinoma were retrospectively analyzed. The survival rate was calculated by Kaplan-Meier method. The significance was analyzed by log-rank test, univariate and multivariate analysis with COX risk Proportional regression model. Results: The clinical features of 65 patients with pulmonary neuroendocrine carcinoma had no significant difference (P> 0.05). The changes of the gene status were mainly PIK3CA gene mutation, small cell carcinoma (26.7 months), large cell neuroendocrine carcinoma (30.4 (P = 0.039). The single-factor analysis of SLC showed that there was a significant difference in genotypes, cancer stage and difference (P <0.05). CONCLUSIONS: The changes of endogenous neuroendocrine genes in the lung are rare. PIK3CA gene mutation is the main pathological type. The expression patterns of endogenous neuroendocrine carcinomas in lung are abundant and the expressions of different subtypes are different. The survival rate of carcinoid tumors is significantly higher than that of pulmonary neuroendocrine carcinomas and small cells cancer.