Abstract
背景与目的非小细胞肺癌(non-small cell lung cancer, NSCLC)伴神经内分泌分化(neuroendocrine differentiation, NED)是一个新的病理分类，在临床中并不常见，本文拟探讨NSCLC-NED的临床病理特征、影像学特点、治疗及预后。方法收集解放军总医院第五医学中心2009年1月-2017年11月期间收治的47例NSCLC-NED患者的临床资料，总结其人口学资料、影像学特点、病理特征及治疗和预后，分析不同因素与预后之间的相关性。结果47例NSCLC-NED患者中，中位年龄61岁(45岁-78岁)，男性38例，女性9例; 37例为低分化癌伴NED，10例为中分化癌伴NED; 2例驱动基因阳性(1例为EGFR敏感突变，1例为ALK融合)，一线化疗的客观有效率(objective response rate, ORR)为34.5%，中位无进展生存期(progression-free survival, PFS)为4个月; 整体中位总生存期(overall survival, OS)为11个月，OS超过2年者仅2例(4.2%, 2/47)。结论NSCLC-NED不同于单纯的NSCLC或肺神经内分泌肿瘤，男性、≤70岁、重度吸烟、肿瘤分化程度较低者较常出现NED，且发病时多为Ⅳ期。该类患者驱动基因阳性比例低于普通腺癌人群，对化疗较不敏感，总生存期偏短，提示预后较差。
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