CAJ | 학술논문

目的：回顾性分析和比较复合性小细胞肺癌（combined small cell lung cancer，CSCLC）与单纯性小细胞肺癌（pure small cell lung cancer，PSCLC）预后及其影响因素。方法：收集天津医科大学肿瘤医院2006年1月至2010年12月首诊并经病理证实为小细胞肺癌343例，回顾其临床病理特征，对预后及影响因素进行分析。结果：CSCLC中位总生存期（overall survival，OS）为31个月，中位无进展生存期（progression free survival，PFS）为21个月，PSCLC的中位OS为15个月，中位PFS为9个月。Kaplan-Meier结果显示CSCLC的预后明显好于PSCLC。Cox分析结果提示分期、病理分型与治疗方式是影响总体小细胞肺癌OS的独立影响因素。单因素分析显示，小细胞肺癌尤其是CSCLC更受益于手术为主的治疗方式。在PSCLC组，中性淋巴细胞比率（neutro-phil-lymphocyte ratio，NLR）、治疗方式和分期影响预后，而分期和治疗方式影响CSCLC的预后。多因素分析显示分期和治疗方式均为影响CSCLC的独立影响因子。结论：CSCLC与PSCLC相比预后较好。局限期的小细胞肺癌尤其是CSCLC应采取手术为主的治疗。
목적：회고성분석화비교복합성소세포폐암（combined small cell lung cancer，CSCLC）여단순성소세포폐암（pure small cell lung cancer，PSCLC）예후급기영향인소。방법：수집천진의과대학종류의원2006년1월지2010년12월수진병경병리증실위소세포폐암343례，회고기림상병리특정，대예후급영향인소진행분석。결과：CSCLC중위총생존기（overall survival，OS）위31개월，중위무진전생존기（progression free survival，PFS）위21개월，PSCLC적중위OS위15개월，중위PFS위9개월。Kaplan-Meier결과현시CSCLC적예후명현호우PSCLC。Cox분석결과제시분기、병리분형여치료방식시영향총체소세포폐암OS적독립영향인소。단인소분석현시，소세포폐암우기시CSCLC경수익우수술위주적치료방식。재PSCLC조，중성림파세포비솔（neutro-phil-lymphocyte ratio，NLR）、치료방식화분기영향예후，이분기화치료방식영향CSCLC적예후。다인소분석현시분기화치료방식균위영향CSCLC적독립영향인자。결론：CSCLC여PSCLC상비예후교호。국한기적소세포폐암우기시CSCLC응채취수술위주적치료。
Objective:This study aimed to analyze and compare the prognosis and the prognostic factors of combined small cell lung cancer (CSCLC) and pure small cell lung cancer (PSCLC) retrospectively. Methods:The clinicopathological characteristics of the 343 small cell lung cancer patients who were diagnosed in Tianjin Medical University Cancer Institute and Hospital between January 2006 and December 2012 were collected and reviewed. Survival analysis was performed and prognostic factors were assessed. Results:The median OS (overall survival) and PFS (progression free survival) of CSCLC were 31 and 21 months, respectively, and the median OS and PFS of PSCLC were 15 and 9 months, respectively. The Kaplan-Meier survival curves revealed that the prognosis of CSCLC was significantly better compared with that of PSCLC. COX analysis showed that disease stage, pathology, and therapy were indepen-dent prognostic factors of small cell lung cancer. Univariate analysis indicated that the small cell lung cancer group benefited from the surgery, particularly the CSCLC. NLR , therapy, and disease stage influenced the prognosis of PSCLC, and disease stage and therapy in-fluenced the prognosis of CSCLC. Multivariate analysis revealed that disease stage and therapy were independent risk factors of CSCLC in regard to OS. Conclusion:The prognosis of CSCLC was better compared with that of PSCLC. Limited-stage small cell lung cancer should undergo surgery, particularly the CSCLC.