子宫颈小细胞癌临床病理观察

目的：：探讨宫颈小细胞癌的临床病理特征、免疫组化特点、治疗及预后。方法：回顾性分析8例 SCCC 患者的临床病理资料,并采用免疫组化 SP 法检测 Syn、CgA、CD56、NSE、CK、P16、P63、CK5/6、CD117、TTF-1、Ki-67的表达,结合文献进行分析。结果：8例患者,以阴道不规则出血或宫颈接触性出血就诊。组织学上肿瘤细胞卵圆形或短梭形,小且较为一致,胞质少或无,染色质细颗粒状,胞核深染,核仁不明显,核分裂象多见,伴大片坏死。其中2例合并鳞状细胞癌成分,3例合并腺癌成分。免疫组化示所有病例 CK 不同程度阳性,神经内分泌标记物阳性比例由高到低依次为 NSE(7/8)、CD56(6/8)、Syn(5/8)、CgA(4/8),且至少有2种以上神经内分泌标记阳性。随访8例患者,2例死亡,2例复发。结论：宫颈小细胞神经内分泌癌恶性程度高,预后差,免疫组化有一定特异性,联合检测可提高诊断准确率。采用以手术为主的综合治疗可改善部分患者的预后。

Clinicopathological Analysis of Small Cell Carcinoma of Uterine Cervix

Objective:To explore the features of clinicopathological and immunohistochemistry,treatment and prognosis of the primary small cell carcinoma of the cervix(SCCC).Methods:We collected 8 cases of SCCC from Changzhou women and children hospital.Clinical and pathological data were analyzed and immunohistochemical detection of SYN,CgA,CD56,NSE,CK,CK5/6,TTF-1, Ki-67,P16、P63、CD117 were performed.Related literature was reviewed.Results:They were presented with symptoms of irregular vaginal bleeding.Microscopically,he tumors were composed of small-sized cells in uniformity with scant cytoplasm,dispersed chromatin, darkly stained nuclei and absence of nucleoli.High mitotic activity with necrosis were also common.2 of 8 cases were mixed with squamous carcinoma and 3 cases were mixed with adenocarcinoma.Immunohistochemically,the rates of the expression of NSE,CD56, SYN,CgA were respectively 7/8,6/8,5/8,4/8 and at least 2 neuroendocrine markers were positive in each case.Follow-up revealed that 2 cases were dead and 2 relapsed.Conclusion:SCCC is rare and highly malignant neoplasm with bad prognosis.Correct diagnosis of SCCC depends on the light microscopic and immunohistochemical analysis.Combined therapy including surgical treatment an chemotherapy/radiation is suggested for the disease.