喉小细胞神经内分泌癌的临床特征  

Clinical features of laryngeal small cell neuroendocrine carcinoma

作　　者：朱莹莹[1] 陈兴明[1] 牛燕燕[1] 亓放[1] 李五一[1] 高志强[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院耳鼻咽喉科,北京100730

出　　处：《中国耳鼻咽喉头颈外科》2012年第12期635-637,643,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的总结喉小细胞神经内分泌癌(laryngeal small cell neuroendocrine carcinoma,LSCNC)的临床特征。方法回顾性分析我院近24年来收治的7例LSCNC患者的临床资料。结果 7例患者中有5例病变来源于声门上区,1例局限于声门下区,另1例喉内病变呈弥漫性。就诊时有4例存在一侧或双侧颈部淋巴结转移,但未见远处转移。全部病理活检明确诊断后接受化疗和放疗,其中4例病变完全缓解,3例已分别无瘤生存41、49和100个月,另1例16个月后出现胰腺、肝脏和腹股沟淋巴结转移,于发病24个月后死亡;3例部分缓解,其中1例20个月后喉肿瘤复发伴肝转移,于发病36个月后死亡;1例发病5个月后死于肺转移,1例患者为喉小细胞神经内分泌癌合并腺癌,随访30个月后失访。结论 LSCNC预后差、易发生颈部淋巴结或远处转移,化疗结合放疗为首选治疗方案。OBJECTIVE To summarize the clinical features of laryngeal small cell neuroendocrine carcinoma （LSCNC） . METHODS The clinical data of all LSCNC patients hospitalized during the recent 24 years were analyzed retrospectively. RESULTS Among all 7 patients with LSCNC, 5 lesions, 1 showed subglottic patients showed supraglottic esion, and the other showed diffuse lesions in the larynx. At the presentation, 4 cases developed cervical metastases either unilaterally or bilaterally, but no distant metastases were found. All patients received chemotherapy and radiotherapy after pathological examination. Complete remission occurred in 4 patients. Three patients so far survived for 41,49 and 100 months respectively. Another patient presented with pancreas, liver and inguinal lymph nodes metastases 16 months later, and died within 24 months. Partial remission occurred in 3 patients. One patient presented with local recurrence and liver metastasis 20 months later, and died within 36 months. One patient died of pulmonary metastasis within 5 months. One patient was diagnosed as LSCNC combined with adenocarcinoma and lost to follow-up after 30 months. CONCLUSION The prognosis of LSCNC is very poor. Cervical and distant metastases are common in LSCNC patients. The combination of chemotherapy and radiotherapy is the treatment of choice.

关 键 词：喉肿瘤 癌 神经内分泌 癌 小细胞 

分 类 号：R739.65[医药卫生—肿瘤]