子宫颈小细胞神经内分泌癌的临床病理分析

Objective To analyse the clinico-pathologic characteristics,diagnosis,therapy and prognostic of small cell neuroendocrine carcinoma of the cervix(SCNCC).Methods The clinic-pathological features of 12 patients with SCNCC treated in Tumor Hospital of Guangxi Medical University,admitted during March 2006 to July 2010,were analyzed retrospectively.Results Of 12 patients,the mean age was 38.7 years(rang 28-57 years),6 had stages Ⅰ b1-Ⅱa,6 had stagesⅡb-Ⅳ.Among 8 patients(Ⅰ b1-Ⅲb)underwent surgery,4 of them received neoadjuvant chemotherapy,8 of them received adjuvant chemotherapy and(or)radiotherapy.All had greater than one-half stromal invasion,4 patients had positive pelvic lymph nodes metastases.The positive ratio of the chromogranin(CgA),synaptophysin,neuronspecific enolase(NSE),cytokeratins(CK),CD56 tested by immunohistochemical staining were 8/12,9/10,4/4,4/4,4/4,respectively.Median follow-up period was 3 months(1-22 months).Among 8 patients underwent surgery,2 patients developed lung metastases,1 patient developed liver and lung metastases,1 patient developed liver metastases concurrently with bone metastases,disease-free survival (DFS)were 3 months(Ⅰ b2 with positive lymph nodes),4.6 months(Ⅱ a),7 months(Ⅰ b1),17 months (Ⅰ b2);2 patient died(8.5 and 11.3 months,respectively)after surgery;4 patients are alive and show no evidence of disease.Among 4 patients untreated,1 patients received concurrent chemoradiation and are alive for 10.1 months.Two patient untreated(Ⅲb,Ⅳ)died after 0.6 and 1.3 months final diagnosis,respectively.One patient Was lost follow-up.Conclusions SCNCC is a highly malignant tumor with rare morbility,propensity for distant spread and dismal prognosis.Final diagnosis of SCNCC depends on pathomorphology and immunohistochemical analysis.Combined therapeutic modalities may in favor of survival in some patients.     

子宫颈小细胞神经内分泌癌的临床病理分析

Objective To analyse the clinico-pathologic characteristics,diagnosis,therapy and prognostic of small cell neuroendocrine carcinoma of the cervix(SCNCC).Methods The clinic-pathological features of 12 patients with SCNCC treated in Tumor Hospital of Guangxi Medical University,admitted during March 2006 to July 2010,were analyzed retrospectively.Results Of 12 patients,the mean age was 38.7 years(rang 28-57 years),6 had stages Ⅰ b1-Ⅱa,6 had stagesⅡb-Ⅳ.Among 8 patients(Ⅰ b1-Ⅲb)underwent surgery,4 of them received neoadjuvant chemotherapy,8 of them received adjuvant chemotherapy and(or)radiotherapy.All had greater than one-half stromal invasion,4 patients had positive pelvic lymph nodes metastases.The positive ratio of the chromogranin(CgA),synaptophysin,neuronspecific enolase(NSE),cytokeratins(CK),CD56 tested by immunohistochemical staining were 8/12,9/10,4/4,4/4,4/4,respectively.Median follow-up period was 3 months(1-22 months).Among 8 patients underwent surgery,2 patients developed lung metastases,1 patient developed liver and lung metastases,1 patient developed liver metastases concurrently with bone metastases,disease-free survival (DFS)were 3 months(Ⅰ b2 with positive lymph nodes),4.6 months(Ⅱ a),7 months(Ⅰ b1),17 months (Ⅰ b2);2 patient died(8.5 and 11.3 months,respectively)after surgery;4 patients are alive and show no evidence of disease.Among 4 patients untreated,1 patients received concurrent chemoradiation and are alive for 10.1 months.Two patient untreated(Ⅲb,Ⅳ)died after 0.6 and 1.3 months final diagnosis,respectively.One patient Was lost follow-up.Conclusions SCNCC is a highly malignant tumor with rare morbility,propensity for distant spread and dismal prognosis.Final diagnosis of SCNCC depends on pathomorphology and immunohistochemical analysis.Combined therapeutic modalities may in favor of survival in some patients.     

子宫颈小细胞癌20例临床分析

目的分析子宫颈小细胞癌的临床特点及预后因素。方法回顾性分析1998年1月至2011年10月辽宁省肿瘤医院20例宫颈小细胞癌患者的临床资料。结果 20例宫颈小细胞癌患者中位年龄46.0岁,≤40岁组8例,>40岁组12例,两组5年生存率分别为10.50%、16.67%,差异有统计学意义(P<0.05)。15例手术患者中,10例淋巴结转移,5例无淋巴结转移,两者5年生存率分别10.00%和28.75%(P<0.05);浸润深度<1/2肌层者6例,≥1/2肌层者9例,两者5年生存率分别为33.33%、11.11%(P<0.05)。FIGO分期Ⅰ～ⅡA期15例,5年生存率为20.10%,ⅡB～Ⅳ期5例,5年生存率为8.30%。在单变量分析中FIGO分期是影响预后的因素之一(P<0.05),但多变量分析表明其对预后的影响并不显著。结论宫颈小细胞癌患者的预后与分期无关,与年龄、浸润深度、是否有淋巴结转移有关,该病理类型有高侵袭性的生物学行为,预后差。     

子宫颈小细胞癌研究进展

宫颈小细胞癌（SCCC）属神经内分泌癌,是一种高度恶性的妇科肿瘤。因恶性度高、进展快、复发率高,早期即可有淋巴结转移及血行播散,故预后差。其诊断以组织病理形态学为基础,联合免疫组织化学标记以提高诊断的准确率,治疗以手术辅以放疗、化疗综合治疗为主。近年对宫颈小细胞癌的研究以个案和小宗病例报道为主,就其临床病理特点及诊断治疗方法等综述。旨在提高宫颈小细胞癌的诊断率,改善患者的治疗及预后。     

子宫颈小细胞癌研究进展

宫颈小细胞癌（SCCC）属神经内分泌癌,是一种高度恶性的妇科肿瘤。因恶性度高、进展快、复发率高,早期即可有淋巴结转移及血行播散,故预后差。其诊断 以组织病理形态学为基础,联合免疫组织化学标记以提高诊断的准确率,治疗以手术辅以放疗、化疗综合治疗为主。近年对宫颈小细胞癌的研究以个案和小宗病例报道为主,就其 临床病理特点及诊断治疗方法等综述。旨在提高宫颈小细胞癌的诊断率,改善患者的治疗及预后。     

宫颈小细胞神经内分泌癌19例临床分析 #br#

目的：探讨宫颈小细胞神经内分泌癌的临床病理特征、治疗及预后特点。方法：回顾性分析2012年6月-2017年9月郑州大学第一附属医院收治的19例宫颈小细胞神经内分泌癌患者的临床病例资料。结果：患者年龄30～63岁,平均（45.8±10.0）岁。肿瘤最大径2～10 cm,平均（4.29±2.43）cm。ⅠB1期7例,ⅠB2期5例,ⅡA1期2例,ⅡB期4例,ⅢB期1例。其中16例合并人乳头瘤病毒18（HPV18）感染,1例合并HPV16感染。17例行根治性手术+术后辅助化疗,其中8例接受新辅助化疗,9例术后接受放疗,余2例未手术者接受放化疗。1年、2年及5年无进展生存率分别为58.6%、50.2%、12.6%,1年、2年及5年生存率分别为72.8%、54.6%、27.3%。单因素分析发现临床分期（＞ⅡA）、合并淋巴结转移、肿瘤大小（＞4 cm）为患者预后的危险因素。结论：宫颈小细胞神经内分泌癌发病率低,恶性程度高,确诊依赖于病理,根治性手术是早期患者的主要治疗方案,辅助化疗具有重要意义。     

女性生殖道小细胞神经内分泌癌

神经内分泌癌起源于人体内广泛分布的神经内分泌细胞,最常见于肺和消化道。通常按瘤细胞分化程度的不同,分为3个类型:类癌(高分化)、不典型类癌(中分化)及小细胞癌(低分化)。女性生殖道小细胞神经内分泌癌十分罕见,恶性程度高,易早期发生血道播散和淋巴结转移,预后极差。现对女性生殖道各部位小细胞神经内分泌癌的临床病理特征和诊治现状作一综述,以期提高临床医生对此类少见肿瘤的认识。     

子宫颈神经内分泌癌12例临床病理分析

目的:分析子宫颈原发性神经内分泌癌的临床病理特点,探讨有效的诊治方法,以期改善预后。方法:回顾分析2003年至2007年收治的12例原发于子宫颈的神经内分泌癌的临床资料。结果:12例患者平均年龄37岁,均行手术治疗,术前化疗3例,术后化疗2例,放疗4例,同期放化疗4例,术后发现淋巴结转移4例,脉管浸润10例。随访10例中死于复发1例(IB期),出现肝脏转移但存活1例(IB期),无瘤生存8例。结论:子宫颈神经内分泌癌恶性度高,易早期转移,短期复发且复发后对后续治疗可能抵抗,其治疗多采取手术及放化疗联合治疗,目前尚无有效的成熟方案,预后差。     

子宫颈高级别神经内分泌癌临床病理及预后分析

目的:评价子宫颈高级别神经内分泌癌(HGNECC)患者预后相关的临床和病理危险因素,为临床诊治提供参考和新思路。方法:回顾分析郑州大学第一附属医院2010年6月至2021年6月收治的72例HGNECC患者的临床病理及随访资料,通过Kaplan-Meier法及Log-rank检验进行单因素生存分析,采用Cox风险比例模型进行预后相关的多因素分析。结果:(1)临床病理特点：72例HGNECC患者的中位发病年龄为46.5岁(24～71岁),临床表现以不规则阴道流血或接触性出血为主(86.1%,62/72),免疫组化标志物阳性表达率分别为神经细胞黏附分子(NCAM/CD56)81.9%(59/72)、神经元特异烯醇化酶(NSE)87.5%(63/72)、突触素(Syn)79.2%(57/72)、嗜铬粒蛋白A(CgA)52.8%(38/72),Ki-67阳性率为100%,其中Ki-67≥55%者占76.4%(55/72);(2)生存及复发情况：中位无进展生存期(PFS)为35个月(1～102个月),中位总生存期(OS)为42个月(2～116个月),随访期间,死亡38例,复发或转移者27例,3年和5年总生存率分别为63.9%和51.4%;(3)单因素分析显示,国际妇产科联盟(FIGO)2018年分期≥ⅠB3期、淋巴结阳性[盆腔和(或)腹主动脉旁淋巴结转移]、病灶中单纯HGNECC癌成分、宫旁浸润、淋巴脉管间隙浸润(LVSI)、CgA阳性及Ki-67≥55%是影响HGNECC患者预后的危险因素(P<0.05);(4)多因素分析显示,FIGO分期≥ⅠB3期、淋巴结阳性及CgA阳性是影响HGNECC患者PFS的独立危险因素(HR>1,P<0.05),而FIGO分期≥ⅠB3期、淋巴结阳性及Ki-67≥55%是影响HGNECC患者OS的独立危险因素(HR>1,P<0.05)。结论:HGNECC是一种罕见的子宫颈恶性肿瘤,主要临床表现为不规则阴道流血及接触性出血,易发生复发及转移,预后较差。FIGO分期≥ⅠB3期及淋巴结阳性是影响HGNECC患者预后的独立危险因素。CgA及Ki-67是HGNECC患者预后的潜在影响因素,或可成为HGNECC预后评估的有效标志物。     

宫颈小细胞神经内分泌癌的诊疗进展

宫颈小细胞神经内分泌癌是一种罕见的妇科肿瘤,其形态酷似小细胞肺癌,因恶性度高、进展快、复发率高,早期即可有淋巴结转移及血行播散,故预后差.高危型人乳头状瘤病毒(HPV)(16及18型)感染,神经内分泌标志物阳性以及缺乏普通的癌前病变是宫颈小细胞神经内分泌癌的特征.临床上其很少有激素引起的特异性症状,主要以不规则阴道流血、排液或月经间期出血多见.由于发病率低,迄今尚无前瞻性病例对照研究以制定统一的治疗方案,手术、放疗和辅助化疗相结合的综合治疗能明显改善早期肿瘤患者的预后.就其病理学、分子生物学及诊断、治疗上的研究进展综述.     

子宫颈小细胞癌八例临床病理分析

目的 研究宫颈小细胞癌的临床病理特征、治疗方法和预后.方法 回顾性分析1999年1月至2005年12月间中国医学科学院中国协和医科大学肿瘤医院妇瘤科收治的8例宫颈小细胞癌患者的临床及病理资料.结果 8例患者均表现为不规则阴道流血或接触性出血.临床分期按1994年国际妇产科联盟分期标准为Ⅰ b1期1例、Ⅰ b2期2例、Ⅱ b期2例、Ⅲb期3例.组织学特点为体积小的圆形或短梭形细胞,形态大小较一致,细胞质少,核深染,染色质细,核仁不明显,核分裂象多见.7例行免疫组化染色,神经元特异性烯醇化酶均为阳性.3例Ⅰ b期和1例Ⅲb期患者行手术治疗,术后辅助化疗(或加放疗),生存时间分别为64、22、14和6个月.2例Ⅱ b期和2例Ⅲb期患者行放、化疗,生存时间分别为25、9、10和5个月.结论 联合光镜和免疫组化法检查可提高宫颈小细胞癌诊断的准确率.治疗应采用综合治疗,尤其应重视化疗的作用.     

Large cell neuroendocrine carcinoma of the uterine cervix: a report of a case and review of the literature

Introduction Large cell neuroendocrine carcinoma is a rare aggressive cervical neoplasm, considerably rarer than the well-recognized small cell neuroendocrine carcinoma of the cervix. Cervical large cell neuroendocrine carcinomas are distinctive cervical carcinomas that are frequently misdiagnosed and have an unfavorable outcome, similar to that of small cell carcinoma. Case report We report a 45-year-old woman with large cell neuroendocrine uterine cervical carcinoma.     

Small cell carcinoma of the cervix

Small cell carcinoma of the cervix is an uncommon aggressive variety of cervical cancer. Between 1982 and 1993, eight cases of this disease were diagnosed at the Queensland Centre for Gynaecological Cancer among 1586 cervical cancers. Treatment results have been poor with one long-term survivor. Literature review suggests that aggressive chemotherapy combined with surgery and/or radiotherapy may improve survival.     

宫颈小细胞癌6例临床病理分析

目的探讨宫颈小细胞癌(SCCC)临床病理特点、诊断、治疗和预后。方法回顾性分析2005年1月至2009年10月在北京大学人民医院收治的6例SCCC患者的临床资料,分析临床病理特征及预后。结果6例患者中5例为初次收治的患者,均经手术治疗及术后放/化疗;其中3例术前行新辅助化疗后手术,1例为外院手术后2个月出现盆腔包块而转入北京大学人民医院化疗。另1例仅行2个疗程化疗后放弃治疗,3个月后死亡。全部患者均经病理检查,其中5例经免疫组化确诊。淋巴结转移率为80%(4/5)。患者中3/6例死亡,生存期分别为17、13、3个月。3例仍在治疗随访中,时间分别为8、6、1个月。结论SCCC恶性度高,预后差,死亡率高。其确诊主要依靠病理组织形态学和免疫组化。目前多采用手术、化疗和放疗联合综合治疗。     

宫颈大细胞神经内分泌癌的诊治进展

宫颈大细胞神经内分泌癌(large cell neuroendocrine carcinoma,LCNEC)是一种罕见类型的宫颈恶性肿瘤,因其复发率高,易发生早期转移,具有高度侵袭性,故即使在早期经系统治疗,其预后也极差。宫颈LCNEC临床表现与其他类型宫颈癌无异,目前术前及术后标本的组织病理学及免疫组织化学检查是其主要的诊断方法。一部分宫颈LCNEC患者存在高危型人乳头瘤病毒(HPV)感染,但该病发生与高危型HPV感染无关。由于其独特的生物学特性,所宫颈LCNEC的预后较差,随访较其他类型宫颈癌更加频繁。宫颈LCNEC的治疗方案主要是通过回顾总结得到,目前尚无统一治疗方法。因其与宫颈小细胞神经内分癌有相似的生物学特征,所以其治疗方案主要参考宫颈小细胞神经内分泌癌,主要采用联合治疗方法,手术联合放化疗有助于提高患者的远期生存率,因此有关宫颈LCNEC的诊治研究更为迫切。     

Paclitaxel and carboplatin for large cell neuroendocrine carcinoma of the uterine cervix

The prognosis of large cell neuroendocrine carcinoma (LCNEC) of the uterine cervix is generally poor despite multimodality of treatments. We report a case of advanced stage cervical LCNEC that showed definite response to paclitaxel/carboplatin, resulting in years of survival. The patient was referred to our institution after undergoing a simple hysterectomy with bilateral salpingo-oophorectomy in her local hospital because of a ruptured metastatic ovarian mass. She declined pelvic radiation treatment, so adjuvant chemotherapy (six cycles of paclitaxel/carboplatin) was given for the residual pelvic nodal diseases. Clinical complete remission was obtained, with a disease-free period of 19 months. Systemic recurrent diseases also showed partial response to the same drug regimen for months with only minimal toxicity. However, she subsequently had progressive diseases in the liver and brain and finally died at 44 months after primary diagnosis and 19 months after recurrent diseases.