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背景与目的由于缺乏特异的临床症状,70%的肺癌患者确诊时为局部晚期或晚期,多数患者伴有实性器官转移,不同部位转移患者的临床表现及预后不同。随着诊断技术的发展,肺癌伴胰腺转移似有逐渐增多趋势。本研究针对肺癌胰腺转移的临床特点、诊治、预后及生存情况进行统计分析,探讨肺癌胰腺转移的相关预后因素。方法回顾性分析1996年7月-2017年6月于北京肿瘤医院胸部肿瘤内一科就诊的35例经病理确诊的肺癌并胰腺转移或在治疗过程中出现胰腺转移的患者,其中33例有完整随访资料。结果 35例患者中,小细胞肺癌28例(80%),腺癌3例(8.6%),鳞癌4例(11.4%)。初治时即存在胰腺转移者21例(60%),14例治疗过程中出现胰腺转移(40%)。在胰腺转移灶中,胰头转移者15例(42.9%),胰腺体尾部转移者20例(57.1%),单发转移23例(65.7%),多发转移12例(34.3%)。肺癌胰腺转移患者多无明显临床症状,本组病例中,仅4例患者在病程中出现胰腺炎症状。病理类型是影响肺癌胰腺转移患者生存的独立预后因素。结论部分晚期肺癌患者可以出现胰腺转移,多见于小细胞肺癌。肺癌患者出现胰腺转移,治疗原则以全身化疗为主的综合治疗。病理类型是影响肺癌胰腺转移患者生存的独立预后因素。
BACKGROUND & OBJECTIVE: Due to the lack of specific clinical symptoms, 70% of patients with lung cancer are locally advanced or late diagnosed. Most patients have solid organ metastases. The clinical manifestations and prognosis of patients with different metastases are different. With the development of diagnostic techniques, lung cancer with pancreatic metastasis seems to be gradually increasing trend. In this study, the clinical features, diagnosis and treatment, prognosis and survival of patients with pancreatic metastasis of lung cancer were statistically analyzed to explore the prognostic factors of pancreatic metastasis in lung cancer. Methods From July 1996 to June 2017, 35 patients with pathologically confirmed lung cancer and metastatic pancreatic cancer or pancreatic metastasis during the course of treatment were studied in one of the thoracic tumors of Beijing Cancer Hospital from July 1996 to June 2017, of which 33 patients were complete Follow-up information. Results Of the 35 patients, 28 (80%) had small cell lung cancer, 3 had adenocarcinoma (8.6%), and 4 had squamous cell carcinoma (11.4%). At the time of initial diagnosis, there were 21 cases (60%) of pancreas metastases and 14 cases of pancreas metastasis (40%). Among pancreas metastases, 15 cases (42.9%) had pancreatic head metastases, 20 cases (57.1%) had pancreatic body tail metastases, 23 cases (65.7%) had single metastasis and 12 cases (34.3%) had multiple metastases. There were no obvious clinical symptoms in patients with lung cancer and pancreatic metastasis. In this group of patients, only 4 patients showed symptoms of pancreatitis during the course of the disease. Pathological type is an independent prognostic factor affecting the survival of patients with pancreatic metastasis of lung cancer. Conclusion Some patients with advanced lung cancer may have pancreatic metastasis, more common in small cell lung cancer. Pancreatic metastasis in patients with lung cancer, the principle of treatment with systemic chemotherapy-based comprehensive treatment. Pathological type is an independent prognostic factor affecting the survival of patients with pancreatic metastasis of lung cancer.