宫颈小细胞神经内分泌癌临床病理分析

目的:探讨宫颈小细胞神经内分泌癌(small cell neuroendocrine carcinoma of the cervix,SCNCC)的临床病理和免疫表型。方法:复习4例SCNCC的临床病理资料,并将其组织学特征、免疫表型和预后与宫颈鳞癌进行比较。结果:SCNCC的发病年龄平均38.5岁,多表现为接触性出血或阴道不规则流血、排液。组织学特征为肿瘤细胞小而圆,胞质少,核染色质深染,核仁不明显,分裂象多见,可见坏死,肿瘤细胞呈片状浸润。免疫表型显示4例均表达至少一种神经内分泌标志。4例SCNCC的发病年龄低于宫颈鳞癌,淋巴结转移率高于宫颈鳞癌,近期随访结果显示预后较宫颈鳞癌差。结论:宫颈小细胞神经内分泌癌是一种少见的高度恶性肿瘤,具有独特的病理形态特征,预后较差。免疫组化染色有助于确诊。

Clinicopathologic Study of Small Cell Neuroendocrine Carcinoma of the Cervix

Objective: To study the clinicopathological characteristics and immunophenotype of small cell neuroendocrine carcinoma of the cervix (SCNCC) in comparison to squamous carcinoma of the cervix (SCC). Methods: Clinicopathologic data of 4 cases with SCNCC was retrospectively analyzed, and comparison of histologic characteristics, immunophenotype and prognosis between SCNCC and SCC was performed. Results: In SCNCC the histologic characteristics included small round tumor cells, decreased cytoplasm, trachychromatic nuclear chromatin, inconspicuous chromatospherites and frequently encountered mitotic figures. Necrosis can be seen, with a lamellar tumor cell infiltration. Immunophenotype showed that at least one neuroendocrine marker was expressed in the 4 cases. The age of onset for the 4 cases with SCNCC was lower compared to SCC, but the rate of lymph node metastasis in the SCNCC was higher than in the SCC. A short-term follow-up indicated that the prognosis for patients with SCNCC was poorer than that for patients with SCC. Conclusions: SCNCC is an infrequently occurring tumor of high malignancy with peculiar pathomorphological features and a poor prognosis. Immunohistochemical detection of at least one neuroendocrine marker provides a definitive diagnosis of the disease.