本文關鍵詞： 支氣管肺 神經內分泌腫瘤 臨床特征 治療 預后　出處：《大連醫(yī)科大學》2014年碩士論文　論文類型：學位論文

【摘要】：背景與目的：支氣管肺神經內分泌腫瘤(bronchopulmonary neuroendocrinetumor，BP-NET)是發(fā)生于肺和支氣管上皮的神經內分泌腫瘤，約占所有肺惡性腫瘤的20％。隨著對疾病研究的不斷深入，檢查手段的不斷進步,其發(fā)病率和死亡率均呈逐年上升趨勢，現在多數研究者已不認為其是一種罕見病，但目前相關報道仍較少。BP-NET具有其特殊的生物學行為，共分4個亞型，分別是典型類癌(typicalcarcinoid，TC)、不典型類癌(atypicalcarcinoid，AC)、大細胞神經內分泌癌(large cellneuroendocrine carcinoma，LCNEC)和小細胞肺癌(small cell lung carcinoma，SCLC)。不同亞型BP-NET之間的臨床特征、治療方法及預后存在著顯著的差異。本研究 的目的在于探討B(tài)P-NET的臨床特征、治療方法并分析影響其預后的因素。 方法：回顧性分析2003年1月至2012年12月大連市第三人民醫(yī)院收治的經病理證實的263例支氣管肺神經內分泌腫瘤患者的臨床資料，分析本組患者年齡、性別、吸煙史、遺傳因素、組織學類型、TNM分期及治療等對預后的影響。 結果：263例患者l、3、5年生存率分別為62.7％、25.8％、17.1％，，典型類癌、不典型類癌、大細胞神經內分泌癌及小細胞肺癌的5年生存率分別為83.8％、41．6％、11.8％和3．4％。單因素分析結果顯示，患者的性別、年齡、吸煙史和家族史及是否行放化療均與患者的預后無明顯的相關性，而組織學類型、TNM分期、手術與預后有一定的相關性。多因素回歸分析顯示，TNM分期、手術及放化療是影響預后的主要獨立因素。 結論：目前根治性手術及放化療仍是支氣管肺神經內分泌腫瘤的主要治療手段。影響其預后的獨立因素是TNM分期、手術和放化療。
[Abstract]:Background & objective: bronchopulmonary neuroendocrine tumor (BP-NET) is a neuroendocrine tumor occurring in the lung and bronchial epithelium, accounting for about 20% of all malignant tumors of the lung. The morbidity and mortality of BP-NET have been increasing year by year. Now most researchers do not think it is a rare disease, but there are still few reports about it. BP-NET has its special biological behavior, which is divided into four subtypes. They are typical carcinoid carcinoma, atypical carcinoid carcinoma, large cellneuroendocrine carcinoma and small cell lung carcinoma, respectively. There are significant differences in clinical features, treatment methods and prognosis between different subtypes of BP-NET. The aim of this study was to investigate the clinical features, treatment methods and prognostic factors of BP-NET. Methods: the clinical data of 263 patients with neuroendocrine and bronchopulmonary neoplasms admitted to Dalian third people's Hospital from January 2003 to December 2012 were analyzed retrospectively. The age, sex and smoking history of the patients were analyzed. Genetic factors, histological types, TNM staging and treatment were associated with prognosis. Results the 3- and 5-year survival rates were 62.7% and 25.88%, respectively. The 5-year survival rates of typical carcinoid, atypical carcinoid, large cell neuroendocrine carcinoma and small cell lung cancer were 83.8% and 3.4%, respectively. The history of smoking, family history and radiotherapy and chemotherapy were not significantly correlated with the prognosis of the patients, but the histological type of TNM staging, surgery and prognosis were related to the prognosis. Multivariate regression analysis showed that TNM staging was significant. Surgery, radiotherapy and chemotherapy are the main independent factors affecting prognosis. Conclusion: radical operation, radiotherapy and chemotherapy are still the main treatment methods for neuroendocrine tumor of bronchus and lung. The independent factors influencing the prognosis are TNM stage, operation, radiotherapy and chemotherapy.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R739.4

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