Ua ke SCLC Clinical And Pathological Aspects
Sep 06, 2023
Abstract
Combined me me cell lung carcinoma (C-SCLC) tsis tshua muaj thiab suav rau 1-3% ntawm tag nrho cov mob ntsws cancer. Txawm hais tias nws qhov xwm txheej tau nce tsis ntev los no, muaj kev tshawb fawb tsawg ntawm nws. Cov ntaub ntawv ntawm cov neeg mob tau mus rau hauv peb lub tsev kho mob thaum lub Ib Hlis 2015 thiab Lub Kaum Ob Hlis 2019 thiab kuaj pom nrog cov pov thawj histologically ua ke cov hlwb me me tau raug tshuaj xyuas rov qab thiab tshuaj xyuas. 31 tus neeg mob tau txheeb xyuas. Qhov nruab nrab lub sij hawm rov qab yog 10 lub hlis. Tus nqi hluav taws xob kho mob (RT) tus nqi, kev phais mob, thiab qhov loj ntawm cov cell malignancy tau qis qis dua hauv pawg qub dua li hauv pawg neeg nyob (p=0.024, p=0.023, p{{11} }}.015). Tus nqi ntawm cov kab mob uas nws kim heev, metastasis, thiab thyroid transcription factor 1 (TTF1) tau ntau dua nyob rau hauv pab pawg qub dua li hauv pab pawg neeg nyob (p=0.000, p=0. {18}}, p=0.029, raws). Nyob rau hauv tus qauv univariate, sequential RT, qaug zog, lactate dehydrogenase (LDH), theem, metastasis, contralateral ntsws metastasis, thiab tshuaj kho mob tau pom tias muaj txiaj ntsig zoo hauv kev kwv yees lub sijhawm muaj sia nyob (p=0.000, p{23}}.050, p=0.011, p=0.004, p=0.004, p=0.045, p{{33} }.009). Hauv cov qauv sib txawv, kev ywj pheej (p=0.015, p=0.022, p=0.049) kev ua tau zoo ntawm RT, theem, thiab tshuaj tua kab mob hauv kev kwv yees kev ciaj sia tau pom. C-SCLC yog ib hom kab mob sib xyaw ua ke thiab cov ntawv ceeb toom ntsuas cov hom no tseem tsawg. Cov theem ntawm tus kab mob, radiotherapy, thiab chemotherapy yog ib qho tseem ceeb heev rau kev kwv yees txoj sia nyob.
Cistanche tuaj yeem ua raws li kev tiv thaiv kev qaug zog thiab lub zog ua kom muaj zog, thiab cov kev tshawb fawb sim tau pom tias decoction ntawm Cistanche tubulosa tuaj yeem tiv thaiv daim siab hepatocytes thiab endothelial hlwb puas hauv cov nas ua luam dej hnyav, txhawb kev qhia ntawm NOS3, thiab txhawb cov kab mob siab glycogen. synthesis, yog li exerting los tiv thaiv qaug zog. Phenylethanoid glycoside-nplua nuj Cistanche tubulosa extract tuaj yeem txo cov ntshav creatine kinase, lactate dehydrogenase, thiab lactate qib, thiab nce qib hemoglobin (HB) thiab piam thaj hauv ICR nas, thiab qhov no tuaj yeem ua lub luag haujlwm tiv thaiv kev qaug zog los ntawm kev txo qis cov leeg nqaij. thiab ncua lub lactic acid enrichment rau lub zog cia hauv nas. Compound Cistanche Tubulosa ntsiav tshuaj ua rau lub sijhawm ua luam dej hnyav, nce siab glycogen cia, thiab txo qis qib urea tom qab kev tawm dag zog hauv cov nas, qhia nws cov nyhuv tiv thaiv kev qaug zog. Lub decoction ntawm Cistanchis tuaj yeem txhim kho kev ua siab ntev thiab ua kom lub cev qaug zog hauv kev tawm dag zog nas, thiab tuaj yeem txo qhov siab ntawm cov ntshav creatine kinase tom qab kev tawm dag zog thiab ua kom lub cev nqaij daim tawv nqaij ntawm cov nas ib txwm muaj tom qab kev tawm dag zog, uas qhia tau hais tias nws muaj cov teebmeem. ntawm kev txhim kho lub cev muaj zog thiab tiv thaiv qaug zog. Cistanchis kuj tseem ua rau lub sijhawm muaj sia nyob ntawm cov nas uas muaj nitrite-poisoned thiab txhim kho lub siab ntev tiv thaiv hypoxia thiab qaug zog.
Nyem rau ntawm kev puas siab puas ntsws
【Yog xav paub ntxiv:george.deng@wecistanche.com / WhatsApp:8613632399501】
Ntsiab lus:Tshuaj kho mob; radiotherapy; ua ke me me cell carcinoma.
Kev koom tes:FC, kawm tsim, sau thiab txhais lus, sau ntawv; SD, sau thiab txhais cov ntaub ntawv; SA, kawm tsim. Txhua tus kws sau ntawv tau nyeem thiab pom zoo rau qhov kawg ntawm cov ntawv sau thiab pom zoo kom lav ris rau txhua yam ntawm txoj haujlwm.
Kev tsis sib haum xeeb: Peb tshaj tawm tias tsis muaj qhov tsis sib haum xeeb ntawm kev txaus siab, tshwj xeeb tshaj yog tsis muaj nyiaj txiag muaj feem cuam tshuam rau cov ntsiab lus ntawm cov ntawv sau.
Kev pom zoo Ethics:Peb txoj kev tshawb fawb tau pom zoo los ntawm Pawg Neeg Saib Xyuas Kev Ncaj Ncees ntawm Atatürk Chest Diseases Thoracic Surgery Training and Research Hospital nrog hnub tim 11.06.2020 thiab txiav txim siab tus lej 677.
Nyiaj txiag:Tag nrho cov kev txhawb nqa rau txoj kev tshawb no yog los ntawm cov chaw haujlwm thiab cov chaw haujlwm. Txoj kev tshawb no tsis tau txais ib qho nyiaj pab tshwj xeeb los ntawm cov koom haum pab nyiaj hauv pej xeem, kev lag luam, lossis tsis tau txais txiaj ntsig.
Tau txais kev tshaj tawm:7 Lub Ob Hlis 2022. Tau txais kev tshaj tawm: 31 Tsib Hlis 2022.
Publisher daim ntawv:Txhua qhov kev thov uas tau hais hauv tsab xov xwm no tsuas yog cov neeg sau ntawv nkaus xwb thiab tsis tas yuav sawv cev ntawm lawv cov koom haum koom nrog, lossis cov tshaj tawm, cov neeg kho, thiab cov neeg tshuaj xyuas. Txhua yam khoom uas yuav raug soj ntsuam nyob rau hauv tsab xov xwm no los yog thov uas tej zaum yuav ua los ntawm nws cov chaw tsim tshuaj paus yuav tsis guaranteed los yog pom zoo los ntawm lub publisher.
Taw qhia
Mob ntsws cancer yog ib qho ntawm cov ua rau mob qog noj ntshav txog kev tuag rau ob tug poj niam txiv neej thoob ntiaj teb. Kwv yees li 15% ntawm tag nrho cov qog nqaij hlav ntsws yog cov mob ntsws me me (SCLC) [1].
Combined me me cell lung carcinoma (CSCLC) yog ib hom kab mob histopathological ntawm SCLC. Kwv yees li ntawm 10-25% ntawm SCLC cov neeg mob tau ua ke SCLC. Lub Koom Haum Saib Xyuas Kev Noj Qab Haus Huv Ntiaj Teb (WHO) txhais CSCLC ua cov kab mob qog nqaij hlav me me nrog rau cov khoom ntxiv ntawm txhua yam tsis yog cov cell histological. [2]. Thaum adenocarcinoma (ADC), squamous cell carcinoma (SCC), loj cell carcinoma (LCC), thiab loj cell neuroendocrine carcinoma (LCNEC) cov khoom muaj ntau dua ntawm C-SCLC constituents, cov no tau pom tsawg zaus nrog giant cell carcinoma (GC) [3]. C-SCLC raug kuaj pom thaum ADC, SCC, lossis mob qog noj ntshav sarcomatoid ua ke nrog SCLC, tsis hais cov xov tooj ntawm tes. Rau kev kuaj mob C-SCLC, txawm li cas los xij, tsawg kawg yog 10% LCC (lossis LCNEC) yuav tsum tau. Lub Koom Haum Ntiaj Teb Kev Noj Qab Haus Huv / Lub Koom Haum Thoob Ntiaj Teb rau Kev Tshawb Fawb Kev Mob ntsws (WHO / IASLC) tau faib SCLC rau hauv peb pawg neeg dawb huv, sib xyaw, thiab ua ke me me cell carcinomas [4].
Hauv kev sib piv rau qhov kev nce qib tsis ntev los no hauv cov txheej txheem kuaj mob, qhov tshwm sim ntawm C-SCLC tau muaj kev nce ntxiv [5]. C-SCLC muaj ntau yam NSCLC Cheebtsam. Yog li ntawd, nws muaj qhov sib txawv tseem ceeb ntawm cov ntshiab SCLC hais txog kev lom neeg, kev kho mob, molecular, thiab pathological yam. Zuag qhia tag nrho, SCLC yog qhov mob hnyav tshaj plaws ntawm hom mob ntsws cancer loj tshaj plaws, nrog rau qhov kev mob tshwm sim ntev tshaj plaws thiab muaj sia nyob [6]. C-SCLC theem, kev kho mob, thiab kev soj ntsuam zoo ib yam li cov SCLC. Tam sim no, C-SCLC tau kho nrog kev phais, xov tooj cua, thiab tshuaj khomob raws li SCLC cov lus qhia. Ua raws li kev kho mob sai sai ua rau tuag taus. Cov mob C-SCLC muaj qhov pom zoo dua piv rau cov tib neeg uas muaj mob qog noj ntshav dawb huv uas tau txais txiaj ntsig los ntawm kev phais.
Vim muaj cov kev tshawb fawb me me thiab cov lus ceeb toom ntawm C-SCLC; Cov kev kho mob, cov qauv kho kom zoo, thiab cov xwm txheej prognostic tseem tsis tau meej meej. Tam sim no, kev tshawb fawb soj ntsuam kev sib xyaw ua ke ntawm cov qog nqaij hlav qog nqaij hlav me me (C-SCLC) muaj tsawg thiab tsawg. Peb txoj kev tshawb fawb tsom mus tshawb xyuas qhov chaw kho mob thiab cov xwm txheej prognostic ntawm CSCLC, nrog rau lub luag haujlwm ntawm kev kho ntau yam.
Cov ntaub ntawv thiab cov txheej txheem
Tom qab kev pom zoo ntawm Pawg Neeg Saib Xyuas Kev Ncaj Ncees, cov ntaub ntawv hauv tsev kho mob ntawm cov neeg mob qog nqaij hlav qog nqaij hlav me me uas muaj hnub nyoog tshaj 18 xyoo tau lees paub thaum Lub Ib Hlis 2015 thiab Lub Kaum Ob Hlis 2019 tau rov qab tshuaj ntsuam xyuas ntawm Ankara Atatürk Chest Diseases thiab Chest Surgery Training and Research Hospital pib txij Lub Ib Hlis 2020. Cov pej xeem, soj ntsuam, thiab kuaj tsis, staging status, txoj kev kho mob, thiab prognostic cov ntaub ntawv ntawm cov neeg mob raug tshuaj xyuas retrospectively. Nyob nruab nrab ntawm lub xyoo no, 313 tus neeg mob tau kuaj pom tias muaj mob qog noj ntshav hauv lub ntsws me me, thaum 31 tus neeg mob tau kuaj pom tias muaj cov qog nqaij hlav me me hauv lub ntsws. Staging suav nrog positron emission tomography (PET) lossis PET / CT. Lub paj hlwb metastasis tau soj ntsuam los ntawm kev siv magnetic resonance imaging (MRI) lossis xam tomography (CT).
Raws li kev pom zoo los ntawm Lub Koom Haum Thoob Ntiaj Teb rau Kev Tshawb Fawb Txog Kev Nyuaj Siab, qhov txwv-theem TNM yog sib npaug rau theem I-III thiab kev qhia-theem TNM yog sib npaug rau theem 4 [7]. Qhov yuav tsum tau muaj kev pom zoo los ntawm cov neeg mob raug zam vim qhov rov qab los ntawm txoj kev tshawb no. Kev ceev ntiag tug ntawm tus neeg mob cov ntaub ntawv tau khaws cia thoob plaws qhov kev tshawb fawb.
Kev txheeb cais
Hauv kev piav qhia ntawm cov ntaub ntawv, txhais tau tias, tus qauv sib txawv, qhov nruab nrab qhov tsawg kawg nkaus-qhov siab tshaj plaws, zaus, thiab qhov sib piv tau siv. Kev faib tawm ntawm qhov sib txawv tau ntsuas nrog Kolmogorov-Smirnov xeem. Qhov kev xeem Mann-Whitney U tau siv rau hauv kev tshuaj xyuas ntawm cov ntaub ntawv ywj pheej ntau. Kev ntsuas chi-square tau siv rau kev soj ntsuam ntawm cov ntaub ntawv muaj txiaj ntsig zoo, thiab Fischer xeem tau siv thaum qhov kev ntsuas chi-square tsis tau raws li. Cox regression (univariate-multivariate) thiab Kaplan Meier tau siv rau kev ntsuas kev ciaj sia. SPSS 27.0 qhov kev pab cuam tau siv rau hauv kev tshuaj xyuas.
Cov txiaj ntsig
The male/female ratio of our patients was 24/7, and the mean age was 59. The most common symptoms were shortness of breath, cough, chest pain, and fatigue. Most of the cases were diagnosed by bronchoscopic biopsy. In the histopathological examination, 15 cases were diagnosed with small cell + squamous cell, 9 cases with small cell + large cell, and 7 cases with small cell+adenocarcinoma (Table 1). Table 1 shows the patients' age, gender, smoking history, symptoms, type of tumor, diagnosis methods, laboratory and treatment methods. The location of the tumor was predominantly the central and right upper lobe. 11 cases had limited disease and the remaining 20 cases had extensive disease. Areas of metastasis at diagnosis were contralateral lung (n=7), bone (n=6), brain (n=5), and liver (n=5). The mean follow-up period of the patients was 10 months (Table 2). Table 2 shows tumor characteristics, location, tumor stages, molecular and pathological aspects, treatments applied, and survival durations. Age, gender distribution, chemotherapy (CT), and concomitant chemoradiotherapy CRT ratio did not differ significantly between the ex and the living groups (p>0.05). The radiotherapy (RT) rate of the ex-group was significantly (p=0.024) lower than that of the living group (Table 3). The rate of SCC, adeno additional malignancy did not differ significantly between the ex and the living groups (p>0.05). The large cell malignancy rate of the ex-group was significantly (p=0.015) lower than that of the living group (Table 3). There was no significant difference between the family history and smoking history ratio, smoking habit, diagnosis method, symptom distribution, neutrophil to lymphocyte ratio (NLR), C-reactive protein (CRP), and lactate dehydrogenase (LDH) values (p>0.05) of the ex and living groups (Table 3). Tumor central/peripheral ratio, tumor location, tumor SUV max value, tumor diameter, and metastasis area distribution did not differ significantly between the ex and surviving groups (p>0.05) (Table 4). The rate of extensive disease and metastasis of the ex-group was significantly higher (p=0.000, p=0.000) than that of the living group (Table 4). The rates of pleural effusion, epidermal growth factor receptor (EGFR), anaplastic lymphoma kinase (ALK), reactive oxygen species (ROS), and CD 56 did not differ significantly (p>0.05) between the ex-group and the living group. The thyroid transcription factor 1 (TTF1) rate of the ex group was significantly (p=0.029) higher than that of the living group. The ratio of cytokeratin, chromogranin, and napkin did not differ significantly between the ex and the living groups (p>0.05) (Table 4). The surgical rate of the ex-group was significantly (p=0.023) lower than that of the living group. Surgical technique distribution, chemotherapy, and targeted therapy rates did not differ significantly between the ex and the living groups (p>0.05) (Table 4). In predicting the survival duration in the univariate model; no significant efficacy (p>0.05) hnub nyoog, poj niam txiv neej, kev kho mob raws sij hawm, kev siv tshuaj kho mob sib xyaw ua ke (CRT), mob qog noj ntshav ntxiv, tsev neeg keeb kwm, kev haus luam yeeb, kev kuaj mob, hemoptysis, hnoos, dyspnea, mob hauv siab, NLR, CRP, qog nqaij hlav, qog qhov chaw, qog txoj kab uas hla, qog SUV max, daim siab metastases, pob txha metastases, hlwb metastases, pleural metastases, pericardial metastases, spleen metastases, plab metastases, adrenal metastases, pleural effusion, EGFR, ALK, ROS, TTF6, nanog, , phais, phais txheej txheem, thiab cov hom phiaj kho tau raug pom. Nyob rau hauv tus qauv univariate, sequential RT, qaug zog, LDH, theem, metastasis, contralateral ntsws metastasis, thiab chemotherapy tau pom tias muaj txiaj ntsig zoo hauv kev kwv yees lub sijhawm muaj sia nyob (p=0.000, p{{6 }}.050, p=0.011, p=0.004, p=0.004, p=0.045, p=0.009 raws ) (Table 5). Qhov tseem ceeb-yooj yim ua tau zoo ntawm cov kab ke RT, theem, thiab tshuaj khomob hauv kev kwv yees lub sijhawm muaj sia nyob tau pom nyob hauv cov qauv sib txawv (p=0.015, p=0.022, p=0.049) (Table 5).
Kev sib tham
Ua ke SCLCs yog 10% mus rau 25% ntawm tag nrho cov mob SCLC thiab raug txhais los ntawm kev sib xyaw ntawm cov ntshiab SCLC thiab adenocarcinoma, squamous cell, cell loj, los yog sarcomatoid (spindle los yog giant cell) carcinoma, tsis hais tus nqi ntawm NSCLC [4,8. ]. Qhov nruab nrab hnub nyoog ntawm cov neeg mob uas muaj C- SCLC, uas yog ib tug histopathological variant ntawm SCLC, yog 59-64 [9,10]. Lub hnub nyoog nruab nrab ntawm peb pawg neeg mob yog 59, uas yog raws li qhov no.
Cov neeg mob C-SCLC feem ntau yog txiv neej, nrog cov nqi ntawm 43% mus rau 82.5% [11,12]. Ib yam li ntawd, tus nqi yog 77.4% rau peb pawg neeg mob. Kev haus luam yeeb keeb kwm yog pom tseeb hauv etiology ntawm C-SCLC. Hauv kev tshuaj xyuas los ntawm Luo li al., keeb kwm kev haus luam yeeb yog 77.5%, uas zoo ib yam li tus nqi hauv peb qhov kev tshuaj ntsuam [10]. NSCLC Cheebtsam hauv C-SCLC feem ntau yog squamous cell carcinoma thiab adenocarcinoma [13]. Hauv peb txoj kev tshawb fawb, txawm li cas los xij, hom tseem ceeb tshaj plaws yog cov khoom siv squamous cell. SCLC thiab loj cell neuroendocrine carcinoma (LCNEC) muaj xws li cov khoom ntawm lwm yam mob ntsws cancer feem ntau piav raws li ua ke SCLC. Loj cell neuroendocrine carcinomas (LCNECs) thiab me me cell lung carcinomas (SCLCs) yog cov qib siab neuroendocrine carcinomas ntawm lub ntsws nrog tus cwj pwm nruj heev thiab cov tsos mob tsis zoo [14]. Txawm li cas los xij, hauv peb txoj kev tshawb fawb, qhov loj ntawm cell malignancy tus nqi ntawm ex-pab pawg tau loj heev (p=0.015) qis dua li ntawm pawg neeg nyob.
Kev kuaj mob hauv C-SCLC feem ntau yog ua nrog cov qauv me me uas tau txais los ntawm bronchoscopic biopsy, transthoracic fine koob aspiration, thiab cytology. Yog vim li cas rau cov ntaub ntawv tsawg yuav yog vim cov qauv me me thiab cov ntaub ntawv cytological tsawg. Hauv lawv txoj kev kawm, Fraire et al. [15] xaus lus tias qhov kev kuaj mob ntawm C-SCLC yog cuam tshuam los ntawm qhov loj thiab kev ncaj ncees ntawm cov kab mob biopsy, thiab cov naj npawb ntawm cov kab mob pathological. Peb pab pawg neeg mob feem ntau raug kuaj mob bronchoscopic biopsy. Cov tsos mob tseem ceeb ntawm C-SCLC yog hnoos, dyspnea, thiab hemoptysis [16]. Hauv peb txoj kev tshawb fawb, dyspnea yog cov tsos mob tseem ceeb tshaj plaws. C-SCLC feem ntau yog nyob hauv nruab nrab (59.1%-86.4%). Luo et al. [5], pom cov duab ntawm lub hauv paus loj hauv 86.4% ntawm cov neeg mob. Hauv peb pawg neeg mob, qhov chaw nruab nrab ntawm qhov chaw yog 71%.
Vim muaj kev pom zoo zoo ntawm qhov kev tshwm sim ntawm SCLC thiab TNM theem, Lub Koom Haum Thoob Ntiaj Teb rau Kev Tshawb Fawb Txog Kev Kho Mob ntsws tau pom zoo siv TNM kev faib tawm rau NSCLC thiab SCLC hauv 7 qhov teeb meem ntawm AJCC [17]. Thaum nkag, 60-70% ntawm cov neeg mob C-SCLC yog nyob rau theem dav [18]. Tus nqi ntawm cov kab mob sib kis yog 64.5% hauv peb pawg neeg mob. Hauv peb txoj kev tshawb fawb, tus nqi ntawm cov kab mob loj thiab cov kab mob metastasis hauv cov pab pawg qub tau siab dua (p=0.000, p=0000) dua li ntawm cov pawg nyob. Prognostic yam rau C-SCLC yog thawj theem [15] thiab hom tsis-SCLC tivthaiv [13]. PET-CT muaj qhov rhiab heev rau staging SCLCs [19]. Txawm hais tias SCLC yog qhov nkag siab rau chemoradiotherapy, cov ciaj sia taus tsawg kawg nkaus vim nws qhov kis tau zoo. Thaum Luo et al. [5] sau cov ntaub ntawv kho mob ntawm 88 tus neeg mob nrog CSCLC, lawv pom qhov nruab nrab OS ntawm theem III thiab IV cov neeg mob yuav yog 10 lub hlis thiab 7.8 lub hlis, feem. Ib yam li ntawd, 64.5% ntawm peb cov neeg mob tau nyob rau hauv pawg kab mob uas nws kim heev thiab lub sij hawm nruab nrab ntawm kev soj ntsuam yog 10 lub hlis.
Several studies have been conducted to measure the prognostic value of TTF-1 for patients with SCLC. Disease-free survival and overall survival were found to be poor for patients with SCLC TTF-1 expression. The study by Yan et al. showed that TTF-1 predicted lower survival in SCLC, which strengthened the prognostic value of TTF-1 [20]. In our study, this result was similar to the literature. The TTF1 rate in the ex-group was significantly (p=0.029) higher than that of the living group. Epidermal growth factor receptor (EGFR) mutations are found in NSCLC. Such mutations are rarer in SCLC. Combined SCLC/adenocarcinoma may include EGFR mutations in patients with a slight smoking history. In some studies, EGFR mutations were found to be 15% in C-SCLC [21]. In our study, a positivity rate was found in 2 patients (7.6%) out of 26 patients whose EGFR was analyzed. Pleural effusion rate, EGFR rate, ALK rate, ROS rate, and CD 56 rate did not differ significantly (p>0.05) nruab nrab ntawm pawg neeg qub thiab pawg neeg nyob hauv peb txoj kev kawm.
Txawm hais tias C-SCLC yog qhov nkag siab zoo rau kev siv tshuaj khomob thiab kev siv hluav taws xob, nws rov qab sai heev thiab ua rau muaj kev tiv thaiv kev kho mob tsis pub dhau 1-2 xyoo. C-SCLC tau kho raws li SCLC cov lus qhia nrog kev siv ntau yam kev kho mob (surgery, radiotherapy, thiab chemotherapy). Cov neeg mob nyob rau theem txwv feem ntau yog kho nrog kev kho mob sib xyaw ua ke, thaum siv tshuaj khomob yog siv nyob rau theem dav. Platinum-raws li kev tswj hwm zoo dua vim lawv txoj sia nyob ntev thiab cov lus teb siab. Thaum SCLC feem ntawm C-SCLC teb tau zoo rau kev kho mob, NSCLC tivthaiv nce. Vim li no, CSCLC raug suav hais tias yog cov tshuaj tiv thaiv kab mob [22]. Cov kev tshawb fawb tau pom tias kev kho mob phais, tshwj xeeb tshaj yog lobectomy, ua rau muaj kev tswj hwm hauv zos, thiab kev muaj sia nyob yog siab dua rau cov neeg mob no [23,24]. Nyob rau hauv txoj kab nrog qhov no, qhov kev phais mob hauv cov pab pawg qub yog qhov tseem ceeb (p=0.023) qis dua li ntawm pab pawg muaj sia nyob hauv peb txoj kev tshawb fawb.
Lactate yog upregulated los ntawm LDH hauv cov qog hlwb. Nws paub tias qib LDH siab yog qhov ua rau tsis zoo nyob rau hauv cov qog nqaij hlav me me. Kev nce qib LDH tuaj yeem cuam tshuam nrog qog loj thiab tus nqi. Rau peb cov neeg mob, qib LDH tau siab nyob rau hauv pawg neeg laus thiab muab qhov kev cia siab tsis zoo. Cov txiaj ntsig no zoo ib yam nrog cov ntaub ntawv dhau los [25].
Hauv peb txoj kev tshawb fawb, kev ua tau zoo ntawm RT, qaug zog, LDH, theem, metastasis, contralateral ntsws metastasis, thiab kws khomob hauv kev kwv yees lub sijhawm muaj sia nyob hauv tus qauv univariate tau pom (p=0.000, p{ {2}}.050, p=0.011, p=0.004, p=0.004, p=0.045, p=0. 009, ib.). Hauv peb txoj kev tshawb fawb, kev ua tau zoo ntawm kev ywj pheej tseem ceeb ntawm RT, theem, thiab tshuaj khomob tau pom nyob rau hauv kev kwv yees lub sijhawm muaj sia nyob hauv ntau hom qauv (p=0.015, p=0.022, p{{19} }.049 ib.).
Ua ke SCLC histology tsis tshua muaj tshwm sim, suav txog 10% txog 25% ntawm tag nrho SCLC mob. C-SCLC yog ib hom kab mob sib xyaw ua ke uas tau txais kev tshawb fawb me ntsis. Nws yog ib qho tseem ceeb kom paub seb hom kev sib xyaw histology koj muaj dab tsi vim nws tuaj yeem hloov koj txoj hauv kev muaj sia nyob.
Cov qog nqaij hlav qog nqaij hlav me me tau kho zoo ib yam li kev sib xyaw ntawm cov qog nqaij hlav me me hauv kev kuaj mob, kev kho mob, thiab kev soj ntsuam. Cov qib TTF1 thiab LDH siab, raws li tau teev tseg hauv peb txoj kev tshawb fawb, yog cov cim tsis zoo, xws li cov theem siab thiab muaj cov metastases. Kev ciaj sia yog nyob ntawm theem ntawm tus kab mob, hluav taws xob, thiab tshuaj kho mob. Txhawm rau kom nkag siab zoo dua kev coj tus cwj pwm thiab kev kwv yees, kev tshawb fawb ntau qhov chaw yuav tsum.
Peb txoj kev tshawb fawb muaj ntau qhov kev txwv, suav nrog kev tsim ib lub hauv paus, kev tshuaj xyuas rov qab, thiab cov qauv me me. Txawm li cas los xij, cov kev soj ntsuam no yuav tsum tau tsim nyob rau hauv cov kev tshawb fawb loj.
Nyob rau hauv lub neej yav tom ntej, peb cia siab tias cov tshuaj chemotherapeutic tshiab thiab cov neeg saib xyuas yuav muaj feem cuam tshuam rau cov lus teb thiab kev muaj sia nyob hauv pawg neeg mob no.
Cov ntaub ntawv
1. Jackman DM, Johnson BE. Small-cell ntsws cancer. Lancet 2005; 366:1385-96.
2. Travis WD. Hloov kho ntawm cov qog nqaij hlav me me thiab nws qhov sib txawv ntawm squamous cell carcinoma thiab lwm cov cell carcinomas uas tsis yog me me. Mod Pathol 2012; 25:S18–30.
3. Travis WD. Xyoo 2015 WHO kev faib tawm ntawm lub ntsws qog. Pathologe 2014; 35:s188.
4. Trawis WD, Brambilla E, Müler-Hermelink K, et al. Cov qog nqaij hlav ntawm lub ntsws. Hauv: Lub Koom Haum Saib Xyuas Kev Noj Qab Haus Huv Ntiaj Teb Kev faib tawm ntawm cov qog, pathology, thiab caj ces, qog ntawm lub ntsws, pleura, thymus, thiab lub plawv. Lyon: IARC; 2004. p. 9-124.
5. Luo J, Ni J, Zheng H. Kev soj ntsuam ntawm 88 tus neeg mob nrog cov kab mob me me ua ke. Zhong Liu 2009; 29:156–9.
6. Travis WD, Travis LB, Devesa SS. Mob ntsws cancer. Cancer 1995; 75:s191-202.
7. van Meerbeeck JP, Fennell DA, De Ruysscher DKM. Small-cell ntsws cancer. Lancet 2011; 378:1741–55.
8. Travis WD, Brambilla E, Burke AP, et al. LEEJ TWG Kev faib cov qog ntawm lub ntsws, pleura, thymus, thiab lub plawv. 4th ed. Geneva: LEEJ TWG; 2015.
9. Babaoohi S, Fu P, Yang M, et al. Ua ke SCLC kev kho mob thiab cov yam ntxwv pathologic. Clin Lung Cancer 2013; 14:113–9.
10. Luo Y, Hui Z, Yang L, et al. [Kev tshuaj ntsuam xyuas ntawm 80 cov neeg mob uas muaj kev sib koom ua ke ntawm cov qog nqaij hlav me me hauv lub ntsws] [Cov kab lus hauv Suav]. Zhongguo Fei Ai Za Zhi 2015; 18:161–6.
11. Zhang C, Yang H, Zhao H, et al. Cov txiaj ntsig kev kho mob ntawm kev phais kho mob ua ke ua ke me me ntawm lub ntsws qog noj ntshav: ib qho kev paub ntawm ob lub koom haum. J Thorac Dis 2017; 9:151–8.
12. Wallace AS, Arya M, Frazier SR, et al. Combined me-cell ntsws carcinoma: ib qho kev paub hauv tsev. Thorac Cancer 2014; 5:57–62.
13. Lvu X, Sun LN, Zhan ZL, et al. [Cov yam ntxwv ntawm Clinicopathological thiab prognosis ntawm ua ke me me cell ntsws cancer] [Cov lus hauv Suav]. Zhongguo Zhong Liu Lin Chuang 2011; 38: 769–72.
14. Lantuejoul S, Fernandez-Cuesta L, Damiola F, et al. Kev faib tawm tshiab molecular ntawm cov cell loj neuroendocrine carcinoma thiab me me ntawm lub ntsws carcinoma nrog cov kev cuam tshuam kho mob. Transl Lung Cancer Res 2020; 9:2233.
15. Fraire AE, Johnson EH, Yesner R, et al. Prognostic tseem ceeb ntawm histopathologic subtype thiab theem nyob rau hauv me me cell ntsws cancer. Hum Pathol 1992; 23:520–8.
16. Men Y, Hui Z, Liang J, et al. Kev nkag siab ntxiv ntawm cov kab mob tsis tshua muaj tshwm sim ntawm kev sib xyaw ua ke me me ntawm lub ntsws qog noj ntshav: cov yam ntxwv kho mob thiab cov xwm txheej prognostic ntawm 114 tus neeg mob. Chin J Cancer Res 2016; 28:486–94.
17. Goldstraw P. IASLC staging phau ntawv qhia hauv thoracic oncology. Editorial Rx Xovxwm; Xyoo 2009.
18. Fushimi H, Kikui M, Morino H, et al. Histologic hloov nyob rau hauv me me cell ntsws carcinoma tom qab kho. Cancer 1996; 77: 278-83.
19. Bradley JD, Dehdashti F, Mintun MA, et al. Positron emission tomography nyob rau hauv tsawg-theem me me-hlwb mob ntsws cancer: kev tshawb fawb yav tom ntej. J Clin Oncol 2004; 22:3248-54.
20. Li X.Y., Li X.Y. et al. Prognostic tus nqi ntawm delta-zoo li protein 3 ua ke nrog thyroid transcription factor-1 nyob rau hauv me me-cell ntsws cancer. Oncol Lett 2019; 18:2254-61.
21. Tatematsu A, Shimizu J, Murakami Y, et al. Epidermal loj hlob yam receptor kev hloov pauv hauv cov qog nqaij hlav qog nqaij hlav me me. Clin Cancer Res 2008; 14:6092–6.
22. Cooper S, Spiro SG. Mob ntsws cancer me me. Kev tshuaj xyuas. Respirology 2006; 11:241-8.
23. Schreiber D, Rineer J, Weedon J, et al. Cov txiaj ntsig ntawm kev ciaj sia nrog kev siv cov kev phais hauv cov theem qis me me ntawm lub ntsws cancer: nws lub luag haujlwm yuav tsum rov ntsuas dua? Cancer 2010; 116:1350–7.
24. Varlotto JM, Recht A, Flickinger JC, thiab al. Lobectomy ua rau pom kev ciaj sia nyob rau theem pib ntawm lub ntsws qog nqaij hlav me me: kev tshuaj xyuas rov qab. J Thorac Cardiovasc Surg 2011; 142:538–46.
25. Maestu I, Xibhwb M, Gomez-Codina J, et al. Pretreatment prognostic yam tseem ceeb rau ciaj sia nyob rau hauv me me-cell ntsws cancer: ib tug tshiab prognostic index thiab validation ntawm peb paub prognostic indices ntawm 341 cov neeg mob. Ann Oncol 1997; 8:547-53.
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