原发灶不明颈部淋巴结转移癌15例  

Cervical carcinoma metastases from unknown primary sites: clinical analysis of 15 patients

作　　者：刘小妹 朱晓霞[1] 张军峰 

机构地区：[1]南方医科大学南方医院放疗科,广州市510515 [2]解放军第二七三医院心肾呼吸内科,新疆库尔勒市841000

出　　处：《实用医学杂志》2016年第21期3531-3533,共3页The Journal of Practical Medicine

基　　金：广东省自然科学基金资助项目(编号:2015A030313253)

摘　　要：目的：探讨原发灶不明颈部淋巴结转移癌（CCUP）的临床特点和治疗情况。方法：纳入15例2000年1月至2015年4月诊治的CCUP患者，回顾性分析其临床特点和治疗情况。结果：全纽CCUP患者中男13例，女2例，鳞癌11例，腺癌1例，低分化癌2例，淋巴上皮样癌1例．全组初治年龄25。71岁。单侧颈部包块14例，双侧颈部包块1例。颈部淋巴结分区：Ⅰ区2例（8％）。Ⅱ区14例（54％），Ⅲ区6例（23％），Ⅳ区4例（15％）；分期：N1 4例（26．7％），N2 9例（60．0％），N3 2例（13．3％）。手术治疗14例，放射治疗7例，化疗11例。随访6—50个月，完全缓解11例，部分缓解2例，进展2例，总体有效率为86．7％。全组1、3年总生存率分别为80％、30％，中位总生存期为30．4个月；全组1、3年无进展生存率分别为76．9％、19．2％，中位无进展生存期为20．4个月；出现原发灶2例；死亡11例。结论：CCUP是一种临床少见的疾病，国内其局部控制率和总体生存率较国外低．结合放射治疗的综合治疗可改善其预后。Objective To study the clinical characteristics and treatment efficacy of CCUP. Methods The clinical data of 15 patients treated between January 2000 and April 2015 were retrospectively analyzed. Results There were 13 men and 2 women. Their ages ranged from 25 to 71 y/o. ll cases had squamous cell carcinomas, 1 case had adenoearcinoma, 2 cases had poorly differentiated carcinoma and 1 case had lymphatic epithelioid carcinoma. 14 cases had unilateral neck involvement and 1 case had bilateral neck involvement. The levels of origin of cervical metastasis were： level Ⅰ 2 cases （8%）, level Ⅱ 14 cases （54%）, level Ⅲ6 cases （23%） and level Ⅳ 4 cases （15%）. The N stage was documented in all patients： N1 4 cases （26.7%）, N2 9 cases （60.0%）, N3 2 cases （13.3%）. All patients were followed up for 6 months-50 months, with an average of 25.6 months.14 patients （93.3%） underwent surgical treatment of cervical metastasis.Radiotherapy was performed in 7（46.7%） patients. Chemotherapy was performed in 11 （73.3%） patients. 11 cases （73.3%） got complete response （CR） and 2 cases （13.3%） got partial response （PR） and 2 cases （13.3%） had disease progression. The overall effective rate was 86.7%. The overall survival （OS） rate of 1, 3, 5 year were 80%, 30% and 80% respectively. The relapse-free survival （RFS） rate of 1, 3, 5 year were 76.9%, 19.2% and 0% respectively. Median survival period is 20.4 months in non-progressive patients. 2 patients developed a primary tumor during the follow-up and 11 patients died. Conclusion CCUP is a rare disease with a low local control rate and overall survival rate. The combination with radiotherapyseems to be effective in improving the prognosis.

关 键 词：颈部淋巴结转移癌 原发灶不明 CCUP 

分 类 号：R739.91[医药卫生—肿瘤]