宫颈小细胞癌27例临床分析  

Clinical Analysis on Small Cell Carcinoma of Uterine Cervix: 27 Cases Report

作　　者：夏蛮[1] 蔡净亭[1] 唐迪红[1] 刘艳琼[1] 杨婷[1] 

机构地区：[1]中南大学湘雅医学院附属肿瘤医院/湖南省肿瘤医院妇瘤科,长沙410013

出　　处：《中国现代手术学杂志》2016年第2期129-132,共4页Chinese Journal of Modern Operative Surgery

基　　金：国家自然科学基金青年基金(81500150);国家自然科学基金项目(81477596)

摘　　要：目的探讨宫颈小细胞癌的临床特点、诊断、治疗和预后。方法回顾性分析2007年10月-2014年10月湖南省肿瘤医院收治的2 7例宫颈小细胞癌患者的临床及病理资料。本组患者年龄22-51岁,中位年龄39岁。27例患者中FIGO分期Ⅰb1期9例,Ⅰb2期7例,Ⅱa1期1例,Ⅱa2期3例,Ⅱb期1例,Ⅲb期4例,Ⅳ期2例。分期为Ⅰb1-Ⅱb期的21例患者均经手术治疗及术后化疗,10例患者于术后接受辅助盆腔放疗,其中1例患者因经济原因中途放弃术后放疗;4例Ⅲb期患者接受了根治性盆腔放疗及化疗;2例Ⅳ期患者单纯接受化疗。结果本组27例患者均获随访,时间2-65个月。Ⅰb1-Ⅱb期的21例患者中,10例患者无瘤生存,7例患者发生肝/肺/骨转移,8例患者死亡,总生存期5-13个月。Ⅲb-Ⅳ期的6例患者中,1例化疗进行中,5例死亡,总生存期3-8个月。单因素分析显示肿瘤大体类型、病理类型、临床分期、肿瘤直径、间质浸润深度及盆腔淋巴结转移与复发未见明显相关性（P〉0.05）。结论宫颈小细胞癌早期即可发生远处转移,预后极差。细胞学异常有助于早期发现宫颈小细胞癌,其确诊主要依靠组织病理学联合免疫组织化学检查。治疗应采用包括手术、放疗和化疗的综合治疗。Objective To evaluate the relative clinical characteristics,therapy and prognosis of small cell carcinoma of cervix（ SCCC）. Methods The clinical data and pathological characteristics of 27 SCCC patients from October 2007 to October 2014 in Hunan provincial tumor hospital were analyzed retrospectively.They aged from 22 to 51 years with the median age of 39 years. The FIGO staging was Ⅰb1 in 9 cases,Ⅰb2in 7 cases,Ⅱa1 in 1 case,Ⅱa2 in 3 cases,Ⅱb in 1 case,Ⅲb in 4 cases and Ⅳ in 2 cases. 21 patients with stageⅠb1 to Ⅱb received surgical intervention of radical hysterectomy and（ / or） bilateral salpingo-oophorectomy and pelvic lymphadenectomy（ and / or） para-aortic lymphadenectomy and chemotherapy. Among them,10 patients were performed adjuvant radiotherapy after surgery,and 1 patient gave up treatment due to economy. 4 patients with stage Ⅲ b were carried out radical pelvic irradiation and chemotherapy. 2 patients with stage Ⅳ only received chemotherapy. Results All 27 cases were followed up for 2 to 65 months.Out of the 21 patients with stage Ⅰ b1 to Ⅱ b,10 cases were obtained tumor-free survival,7 cases were found pulmonary or liver or bone metastasis,and 8 patients died; The overall survival period was 5 to13 months. In 6 cases of stage Ⅲ b to Ⅳ,1 case was receiving chemotherapy,and other 5 cases died; The overall survival period was 3 to 8 months. The SCCC recurrence was not correlated with histological type,pathological type,clinical stage,size,stroma invasion and pelvic lymph node metastasis by univariate analysis（ P〉0. 05）. Conclusions The SCCC has very poor prognosis with the propensity of distant metastases in early stage. Cytological abnormalities can contribute to early detection,while the diagnosis would depend on the histopathology plus immunohistochemical examination. The SCCC patients can be treated by multidisciplinary therapy including surgery,chemotherapy and radiotherapy.

关 键 词：宫颈肿瘤 癌 小细胞 预后 

分 类 号：R737.33[医药卫生—肿瘤]