副肿瘤性库欣综合征 (PCS) 是小细胞肺癌 (SCLC) 的一种罕见但临床上重要的特征，与更差的预后相关。为了确定 SCLC 合并 PCS 患者综合管理的关键考虑因素，我们对 PubMed 和 Web of Science 的相关报道进行了系统回顾，重点关注 SCLC 合并 PCS 病例。该系统评价分析了 1985 年至 2022 年间发表的 61 份报告，共纳入 157 名 SCLC 患者。在 157 名患者中，58 份报告 (95.1%) 中有 132 名 (84.1%) 患者被诊断患有异位库欣综合征。对 22 份报告 (36.1%) 中的 30 名患者 (19.1%) 进行了促肾上腺皮质激素 (ACTH) 的免疫组织化学 (IHC) 染色，结果显示令人鼓舞的结果。在治疗方面，分别有 50 份（81.97%）和 24 份（39.34%）报告使用了化疗和酮康唑。关于死亡原因，感染和癌症同样常见，各有 17 份报告（27.87%）有记录。总之，SCLC 患者中大多数 PCS 病例是由异位激素分泌引起的。为了进行鉴别诊断，建议对特定激素（如 ACTH 或促肾上腺皮质激素释放激素）进行 IHC 染色。在 SCLC 与 PCS 患者的综合治疗中，有效管理皮质醇增多症和有效预防感染起着两个关键作用。最终，IHC 染色技术的特异性和准确性以及免疫疗法治疗 PCS 患者 SCLC 的有效性和安全性还需要进一步确认。版权所有 © 2023 Li、Li、Qi、Yu 和 Lin。

Paraneoplastic Cushing's syndrome (PCS) is a rare, but clinically important feature of small cell lung cancer (SCLC) that is associated with even worse prognosis. To identify key considerations in comprehensive management of SCLC patients complicated with PCS, we conducted a systematic review of relevant reports on PubMed and Web of Science, focusing on SCLC with PCS cases. The systematic review analyzed 61 reports published between 1985 and 2022 with a total of 157 SCLC patients included. Out of the 157 patients, 132 (84.1%) patients across 58 (95.1%) reports were diagnosed with ectopic Cushing's syndrome. The immunohistochemical (IHC) staining for adrenocorticotropic hormone (ACTH) was performed on 30 (19.1%) patients across 22 (36.1%) reports and demonstrated encouraging performance. For treatment, chemotherapy and ketoconazole were utilized in 50 (81.97%) and 24 (39.34%) reports, respectively. Regarding cause of death, infection and cancer were equally frequent, each being recorded in 17 (27.87%) reports. To conclude, the majority of PCS cases in SCLC patients were caused by ectopic hormone secretion. In order to make a differential diagnosis, it is recommended to utilize IHC staining for a specific hormone such as ACTH or corticotropin-releasing hormone. In the comprehensive treatment of SCLC with PCS patients, effective management of hypercortisolism and potent safeguarding against infection play two crucial roles. Ultimately, further confirmations are required regarding the specificity and accuracy of IHC staining technique as well as the efficacy and safety of immunotherapy in the treatment of SCLC with PCS patients.Copyright © 2023 Li, Li, Qi, Yu and Lin.