【摘要】 目的探讨肺肝样腺癌(HAL)的临床特征及预后影响因素。方法检索SEER数据库中2001—2016年根据ICD-O-3/WHO 2008诊断为HAL的所有患者,分析HAL的临床特征及预后影响因素。结果共纳入78例HAL患者,男40例,女38例,男女比例1.05∶1,年龄36～90岁,平均(65.50±11.84)岁。原发病灶位于主支气管(隆凸/肺门)2例(2.56%),肺上叶43例(55.13%),肺中叶2例(2.56%),肺下叶16例(20.51%),未知15例(19.23%)。组织学分级:中分化型3例(3.85%),低分化型20例(25.64%),未分化型4例(5.13%),无高分化型,未知51例(65.38%)。初诊时发生骨转移17例(21.79%),脑转移9例(11.54%),肝转移6例(7.69%)。根据美国癌症联合委员会(AJCC)第7版肺癌分期标准分为Ⅰ期2例(2.56%),Ⅱ期4例(5.13%),Ⅲ期7例(8.97%),Ⅳ期29例(37.18%),未知36例(46.15%)。68例有完整生存资料的患者的1 a生存率、2 a生存率、5 a生存率分别为29.38%、14.39%、5.88%,中位总生存期为5个月。HAL患者预后与是否接受手术、肿瘤分期有关(P<0.05),与年龄、性别、婚姻状况、原发灶位置无关(P>0.05)。结论 HAL常见于老年人,原发病灶常位于肺上叶,多数确诊时为晚期,预后较差。早期发现该病并进行以手术为主的综合治疗可有效延长患者的生存期。更多还原

【Abstract】 Objective To analyze the clinical features and prognostic factors of hepatoid adenocarcinoma of the lung(HAL).Methods All patients with HAL diagnosed according to ICD-O-3/WHO 2008 from 2001 to 2016 in SEER database were searched. To analyze the clinical features and prognostic factors of HAL.Results A total of 78 patients with HAL were selected, including 40 males and 38 females, with a male to female ratio of 1.05∶1. Their age ranged from 36 to 90 years old, with an average age of(65.50±11.84) years old. The primary lesions were located in the main bronchus(carina or hilum) in 2 cases(2.56%), upper lobe in 43 cases(55.13%), middle lobe in 2 cases(2.56%), lower lobe in 16 cases(20.51%) and 15 cases(19.23%) unknown. There were 3 cases(3.85%) of moderately differentiated type of histological grading, 20 cases(25.64%) of poorly differentiated type, 4 cases(5.13%) of undifferentiated type. There was no well differentiated type, and the histological grading of 51 cases(65.38%) were unknown. At initial diagnosis, there were 17 cases(21.79%) with bone metastasis, 9 cases(11.54%) with brain metastasis, and 6 cases(7.69%) with liver metastasis. According to the 7 th edition of American Joint Committee on Cancer(AJCC) about the staging criteria of lung cancer, there were 2 cases of stage Ⅰ(2.56%), 4 cases of stage Ⅱ(5.13%), 7 cases of stage Ⅲ(8.97%), 29 cases of stage Ⅳ(37.18%), and 36 cases(46.15%) were unknown. The 1-year survival rate, 2-year survival rate and 5-year survival rate of 68 patients with complete survival data were 29.38%, 14.39% and 5.88%, and the median overall survival time was 5 months. The prognosis of patients with HAL was related to surgery and tumor stage(P<0.05), but not to age, sex, marital status and location of primary tumor(P>0.05).Conclusion The patients with HAL are common in the elderly. The primary focus is often located in the upper lobe of the lung. Most patients with HAL are diagnosed in the late stage, and the prognosis is poor. Early detection of the disease and surgery-based comprehensive treatment could effectively prolong the survival time.更多还原