宫颈小细胞神经内分泌癌34例的临床分析  

Clinical Analysis of 32 Cases of Small Cell Neuroendocrine Carcinoma of Uterine Cervix

作　　者：刘超霞 张克强 桂玲 肖凌志 杨波 

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

出　　处：《肿瘤药学》2016年第4期296-302,共7页Anti-Tumor Pharmacy

摘　　要：目的 探讨宫颈小细胞神经内分泌癌（SCNECC）患者的临床病理特征,治疗及预后影响因素。方法 收集2011年4月至2015年3月在湖南省肿瘤医院妇瘤科诊治的34例SCNECC患者临床资料。回顾性分析SCNECC患者的生存及复发情况,探讨其预后影响因素。结果 随访截止时间为2015年10月31日,中位随访时间25.3个月（8-56个月）,无失访者。随访期内死亡13例,其1年和2年累积总生存率分别为81.6%和56.5%,中位总生存时间为29个月。15例出现复发、转移,中位复发、转移时间为6个月（0-24个月）;1年和2年累积无进展生存率分别为66.8%和48.7%,中位无进展生存时间为24个月。对25例早期手术患者进行单因素分析显示：SCNECC与宫颈深间质受侵、LVSI、盆腔淋巴结转移、新辅助化疗、术后放疗以及总化疗次数无明显相关性（P〉0.05）。单因素生存分析显示,SCNECC患者的预后与临床分期、总化疗次数明显相关（P〈0.05）;而与年龄、宫颈肿瘤直径、肿瘤成分（指单纯型癌和混合型癌）无明显相关性（P〉0.05）。多因素分析也提示总化疗疗程与预后明显相关（P〈0.05）。结论 对于SCNECC患者,肿瘤分期越晚,预后越差;总化疗次数≥3次可提高患者的预后。Objective To investigate the clinicopathologic characteristics, therapies and prognosis of small cell neuroendocrine carcinoma of the cervix （SCNECC）. Methods Thirty-four cases of SCNECC treated from Apr. 2011 to Mar.2015 at Hunan Cancer Hospital were included in this study. Medical charts and clinical data were retrieved and retrospectively reviewed. The Kaplan-Meier method and Cox regression model were used for survival analysis. The survival and relapse data after treatment was analyzed retrospectively to explore the prognositic factors. Results The follow-up data were updated on Oct. 2015. The median follow-up time was 25.3 months （8 - 56 months）. Thirteen patients died during the follow-up period. The cumulative overall survival （OS） of 1 and 2 years were respectively 81.6% and 56.5%, and the estimated median OS was 29 months. Fifteen cases had recurrence, and the median recurrence time was 6 months （range, 0 - 24 months）. The cumulative progression-free survival （PFS） of 1 and 2 years were respectively 66.8% and 48.7%, and the estimated median PFS was 24 months. The univariate analysis on 25 cases with surgery in early staging showed that deep invasion, LVSI, pelvic lymph nodes involvement, neoadjuvant chemotherapy, adjuvant radiotherapy and total chemotherapy times were all not significantly associated with the prognosis of SCNECC （P〉0.05）. The univariate survival analysis showed that the clinical stages and total chemotherapy times were significant prognostic factors （P〈0.05）, while age, tumor components （simplex or mixed type） and the lesion size of the cervix were not significantly associated with prognosis （P〉0.05）. In addition, the multivariable Cox regression model revealed that the total chemotherapy courses were identified as risk factors for both OS and PFS. Conclusion FIGO stage and chemotherapy courses were important prognostic factors. The advanced SCNECC patients had worse prognosis. Three or more courses of chemotherapy could improve the prognosis of

关 键 词：宫颈肿瘤 神经内分泌癌 预后 

分 类 号：R737.33[医药卫生—肿瘤]