| 王光艳,李 倩,钱露茜.宫颈小细胞癌26例临床病理特征及预后分析[J].肿瘤学杂志,2019,25(6):541-546. |
| 宫颈小细胞癌26例临床病理特征及预后分析 |
| Clinicopathologic Characteristics and Prognosis of 26 Cases with Cervical Small Cell Carcinoma |
| 投稿时间：2019-04-18 |
| DOI：10.11735/j.issn.1671-170X.2019.06.B010 |
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| 中文关键词: 小细胞癌 宫颈肿瘤 病理特点 预后 |
| 英文关键词:small cell carcinoma cervical cancer pathological characteristics prognosis |
| 基金项目:国家自然科学基金（81872126；81572556） |
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| 中文摘要: |
| 摘 要：［目的］ 探讨宫颈小细胞癌的临床病理特征及预后。［方法］ 收集收治的26例宫颈小细胞癌患者的临床资料和随访结果，回顾性分析患者人乳头瘤病毒感染状态（human papillomavirus，HPV）、病理特点、治疗效果及预后。［结果］ 患者中位年龄45岁，Ⅰa~Ⅱa期9例，Ⅱb ~Ⅳ期17例，15例合并HPV感染（13例HPV18感染，2例HPV16感染）。16例患者接受手术、放疗或化疗的单一或两种治疗，10例患者接受手术、放疗和化疗三种方法联合治疗（综合治疗方法）。中位随访时间37个月，至2019年2月，16例患者死亡，总生存率38.5%。合并HPV感染的患者生存率相比未感染HPV患者有下降趋势，但差异无统计学意义（33.3% vs 45.5%，P=0.171）。病理免疫组化诊断标志物突触素（synaptophysin，SYN）、嗜铬粒蛋白A（chromogranin A，CgA）及神经细胞黏附分子56（neuronal cell adhension molecules 56，CD56），三项均阳性患者与其中两项阳性患者相比，生存率差异无统计学意义；而FIGO 2009分期、淋巴结转移、脉管癌栓及治疗方式与患者生存期明显相关。［结论］ 宫颈小细胞癌患者总体预后较差，初诊分期Ⅱb以上、淋巴结转移、脉管癌栓提示预后较差。采用综合治疗的患者生存率明显具有优势，推荐所有分期患者使用。 |
| 英文摘要: |
| Abstract：［Objective］ To analyze the clinicopathological features and prognosis of cervical small cell carcinoma.［Methods］ The clinical data and follow-up results of 26 patients with cervical small cell carcinoma were collected. The status of HPV infection，pathological features，clinical manifestations and prognosis of patients were analyzed retrospectively. ［Results］ The median age of patients was 45 years. There were 9 patients with stage Ⅰa~Ⅱa，17 patients with stage Ⅱb~Ⅳ，and 15 patients with HPV infection. Sixteen patients received surgical treatment and/or radiotherapy or chemotherapy，and 10 patients received comprehensive treatments. Median follow-up time was 37 months. Until February 2019，16 patients died and the overall survival rate was 38.5%. The survival rate of patients with HPV infection trended to lower than that of patients without HPV infection，but there was no significant difference(33.3% vs 45.5%，P=0.171). Three diagnostic markers SYN，CgA and CD56 were determined with immunohistochemistry，the survival outcome of patients with three positive markers or with two positive markers showed no statistically different. In addition，FIGO staging，lymph node metastasis，vascular tumor thrombi and treatment method were significantly associated with survival of patients.［Conclusion］ The overall prognosis of patients with cervical small cell carcinoma is poor. Initial staging，lymph node metastasis and vascular tumor thrombi are correlated with poor prognosis. Comprehensive treatment may improve patients’ survival outcome. |
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