Six cases of primary lung cancer producing granulocyte colony-stimulating factor; clinical and pathological analysis

G-CSF産生肺癌6例の臨床病理学的検討を行った．平均年齢は56才，全例男性で，発熱を主訴に来院した．白血球増多（14000～39000/μl）と血清G-CSF値の上昇（78.0～2150.0pg/ml）のみならず，血小板増多，CRP上昇が認められ，Interleukin-6などG-CSF以外のサイトカインの関与も示唆された．全例完全切除を施行した．組織型は多形癌・大細胞癌・低分化型扁平上皮癌が各2例であった．免疫組織化学染色にてG-CSF産生肺癌であると診断した．進行度は，stage IBが1例，IIBが3例，IIIAが2例であった．術後化学療法は3例に施行した．3年生存はstage IBとIIBの各1例のみで，うち1例は無再発生存中であるが，残りの1例は肺と骨転移で術後36ヵ月に死亡した．他の4例は脳・肝・副腎・骨・胸腔内再発をきたし，術後10ヵ月以内に癌死した．G-CSF産生肺癌は完全切除が行われても予後不良で，有効な補助療法の確立が望まれる．

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