子宫颈小细胞癌临床与病理研究

目的探讨原发性子宫颈小细胞癌（SCCC）的临床病理特征、免疫组化特点及生物学行为。方法复习30例子宫颈小细胞癌的临床病理资料、苏木精-伊红（H-E）染色切片及免疫组化标记，并随访及复习相关文献。结果30例患者平均年龄为4．4岁，临床表现为不规则阴道出血。组织学上肿瘤主要由大小一致的小圆形细胞组成，胞质少，核染色质深，核仁不明显，分裂象活跃，可见坏死。其中8例合并鳞癌或腺癌。免疫组化示30例均表达至少2种神经内分泌标记（NSE、C吕A、syn）。治疗包括手术、放疗、化疗以及三者相结合。5年生存率29．4％。结论宫颈小细胞癌是一种少见的高度恶性肿瘤，具有独特的病理形态特征。免疫组化对诊断SCCC有一定帮助。SCCC侵袭性强，进展快，预后差。

Clinical and pathological Analysis of 30 Cases with Small Cell Carcinoma of the Cervix

Objective To explore the feature in pathology, immunohistochemistry and biological behavior of small carcinom of cervix（SCCC）. Methods The clinical data of 30 cases with SCCC were reviewed, hematoxylin and eosin stained slice, immunohistdogical marker were used, clinical follow-up was performed and the related literature was reviewed. Results In these eases, the average age was 44 years old, irregular vagina bleeding was the most common clinical manifestations. Histologically, the neoplastic cells appeared small, round in solid sheets, scant cytoplasm, hyperchromatic nuclei and absence of nudeoli, Numerous mitotic figures and extensive necrosis were also common findings. The foci of squamous carcinoma or adenocarcinoma were identified in 8 cases. immunohistochemical studies showed immunoreactivity for neuroendocrine mankers, such as NSE, CHG-A and Syn. 30 patients stained positive for at least two neuroendocrine markers. Treatments included surgery, radiation, chemotherapy or a combination of them. 5 year survival rate was 29.4%. Condusions SCCC is a rare and highly malignant tumor with distinct pathological features. Immunohistological staining may be helpful in diagnosis of SCCC. It is aggressive with early metastases and has a poor prognosis.