CAJ | 학술논문

背景与目的肺肉瘤样癌（pulmonary sarcomatoid carcinoma, PSC）是一种罕见的肺部恶性肿瘤，属于非小细胞癌。但因其发病率低，目前治疗方法尚无定论。本研究旨在探讨PSC的临床特点、诊断标准、治疗方法及预后，为临床诊治提供一定依据。方法回顾性分析2000年1月-2013年12月在我院治疗的38例肺肉瘤样癌患者的一般临床资料、吸烟史、临床表现、肿瘤大小、TNM分期、病理与免疫组化结果、诊断方法、治疗方法及预后。使用SPSS 19.0统计软件对结果进行分析，生存期使用Kaplan-Meier法进行分析。结果本组患者年龄26岁-76岁（中位年龄57.5岁），男女比例约为4：1，81.6%的患者有长期大量吸烟史。咳嗽和咯血是最常见的首发症状。全部患者的中位生存期为21个月。1年、3年、5年累计生存率分别为68.4%、31.6%和18.4%。肿瘤大小、TNM分期、肿瘤是否发生远处转移及是否进行手术与患者的预后相关。结论肺肉瘤样癌临床表现无特殊，影响肺肉瘤样癌预后的主要因素有：肿瘤大小、TNM分期、肿瘤是否发生远处转移及是否进行手术。目前，手术根治切除是治疗PSC的关键，其放化疗的综合治疗方式与配伍还需开展更多循证医学的探索。生物靶向药物可为PSC患者的治疗提供新的方向。
배경여목적폐육류양암（pulmonary sarcomatoid carcinoma, PSC）시일충한견적폐부악성종류，속우비소세포암。단인기발병솔저，목전치료방법상무정론。본연구지재탐토PSC적림상특점、진단표준、치료방법급예후，위림상진치제공일정의거。방법회고성분석2000년1월-2013년12월재아원치료적38례폐육류양암환자적일반림상자료、흡연사、림상표현、종류대소、TNM분기、병리여면역조화결과、진단방법、치료방법급예후。사용SPSS 19.0통계연건대결과진행분석，생존기사용Kaplan-Meier법진행분석。결과본조환자년령26세-76세（중위년령57.5세），남녀비례약위4：1，81.6%적환자유장기대량흡연사。해수화각혈시최상견적수발증상。전부환자적중위생존기위21개월。1년、3년、5년루계생존솔분별위68.4%、31.6%화18.4%。종류대소、TNM분기、종류시부발생원처전이급시부진행수술여환자적예후상관。결론폐육류양암림상표현무특수，영향폐육류양암예후적주요인소유：종류대소、TNM분기、종류시부발생원처전이급시부진행수술。목전，수술근치절제시치료PSC적관건，기방화료적종합치료방식여배오환수개전경다순증의학적탐색。생물파향약물가위PSC환자적치료제공신적방향。
Background and objective Pulmonary sarcomatoid carcinoma is a rare histologic subtype of non-small cell lung cancer. hTe effective treatment for this disease has not well deifned due to its extremely low morbidity. hTis study explores the clinicopathological characteristics and prognosis of 38 patients with PSC, so as to provide some clues for its diagnosis and treatment. Methods hTe study enrolled 38 patients with PSC that were diagnosed with histology or cytology in our hospital between January 2000 and December 2013. We retrospectively analyzed general clinical characteristics, smoking history, tumor size, TNM staging, pathology, immunohistochemistry, diagnostic method, treatment and prognosis. We used SPSS 19.0 statistical sotfware and Kaplan-Meier method to analyze our data. Results Patients in this study were aged from 26 to 76 years old (the median age was 57.5 years old). Among all of them, the male to female ratio was 4:1, and 81.6%of patients had smoking history. Cough and hemoptysis were the most common primary symptoms. hTe median survival was 21 months, while one-year survival rate, three-year survival rate and five-year survival rate were 68.4%, 31.6%and 18.4%respectively. Tumor size, TNM staging, distant metastasis and surgery therapy were associated with the prognosis of patients. Conclusion Patients with PSC present with no special symptoms generally. According to our study, factors that affect patients’ prognosis include tumor size, TNM staging, distant metastasis and surgery. Complete resection is the key treatment for PSC patients, but comprehensive chemoradiotherapy needs further exploration in evidence-based medicine. Biological target therapy may give new insight into treatment for PSC.