前列腺小细胞性神经内分泌癌3例临床病理学特征分析  

Clinicopathologic characteristics of prostate small cell neuroendocrine carcinoma

作　　者：温爽[1,2] 郭爱桃[1] 刘爱军[1] 韦立新[1] 王丽宏 侯震波[4] 

机构地区：[1]解放军总医院病理科,北京100853 [2]大连市友谊医院病理科 [3]阳煤集团总医院病理科,山西阳尔045000 [4]淄博市中心医院病理科,山东淄博255036

出　　处：《诊断病理学杂志》2013年第1期25-29,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨前列腺小细胞性神经内分泌癌的临床病理学特征及治疗方法。方法报告3例经病理明确诊断的前列腺小细胞性神经内分泌癌,并复习同期国内报道的23例神经内分泌癌的临床及病理学资料,采用统计学方法分析患者的整体生存率及临床、病理特征与患者生存期的关系。结果 26例患者年龄21～82岁,平均59岁。血清PSA水平20例正常,6例升高。病理学检查21例为单纯性,5例为混合性。12例进行了内分泌治疗,10例行化疗,2例行放疗。确诊时12例伴周围组织或脏器侵犯,8例有淋巴、血管侵犯,9例有远隔脏器的转移。最长随访时间为17个月,截至随访时16例死亡,8例生存,2例失访;中位生存时间为8个月,1年生存率为23.2%。统计学分析结果显示化疗与否与患者生存时间关系密切(P<0.05),而血清PSA水平、手术方式、组织学类型、局部侵犯、淋巴血管侵犯及远隔转移与患者生存时间无相关性(P>0.05)。结论前列腺小细胞性神经内分泌癌恶性程度高,预后很差。确诊主要依靠病理学检查,单纯性患者血清PSA往往不升高;手术与否、是否混合有腺泡腺癌成分以及临床分期均与预后无关;化疗是前列腺小细胞性神经内分泌癌的唯一预后相关因素,对于术前穿刺病理提示为该病的患者,将化疗作为一线治疗可能会提高疗效。Abstract： Purpose To explore the clinicopathologic characteristics and therapeutic methods of small cell neuroendocrine carcinoma of prostate. Methods Three cases of prostate small cell neuroendocrine carcinoma were diagnosed during 1999 to 2011 in the General Hospital of PLA, and the clinicopathological data of the 23 cases summarized, which were collected from the Chinese literature from 1999 to 2011. The overall survival and correlations between different clinicopathologic characteristics were analyzed. Results Patients ranged in age from 21 to 82 years old （mean 59 years）. 18 （69. 2% ） patients showed dysuria, 9 （34. 6% ） patients showed urinary irritation symptoms and 6 （23.1%） patients showed hematnria. Serum PSA lever increased in 20 （76. 9% ） patients and it was normal in 6 （23. 1% ） patients. 5 （ 19. 2% ） cases were mixed and and 21 （ 80. 8% ） were pure in morphology. 14 （53.8%） cases underwent needle biopsies, 5 （19.2%） transurethral resections, and 7 （26. 9% ） radical prostatectomies. Postoperative therapy included endocrine therapy （ 12, 46. 2% ）, chemical therapy （ 10, 38.5% ） and radiotherapy （ 2, 7.7% ）. There were local invasion （12, 46. 2% ）, lymph and vessel invasion （8, 30. 8% ）, and distant metastasis （9, 34. 6% ） when diagnosis. The longest follow-up was 17 months. 16 （61.5%） were died, 8 （30. 8% ） were lived at the time of follow-up, and 2 （7. 7% ） were lost of follow-up. The median survival was 8 months, and 1 year survival rate was 23. 2%. The survival was significantly correlated with chemotherapy （ P 〈 0. 05）, but serum PSA level, surgical procedures, pathological types, therapies, local invasion, lymph vessel invasion, and distant metastasis had no significant relationship with survivalstatistically （P 〉 0. 05 ）. Conclusions Small cell neuroendocrine carcinoma of prostate is a rare neoplasm with high malignancy, metastasizing early and poor prognosis, and 1 year survival rate was 23.2%. Its dia

关 键 词：前列腺 小细胞癌 临床特征 病理特征 预后 免疫组化 

分 类 号：R737.25[医药卫生—肿瘤]