宫颈原发性小细胞癌5例分析  

Clinical Analysis of Primary Cervical Small Cell Cancer:Report of 5 Cases

作　　者：尼华[1] 牛蕾蕾[1] 景兰凯 梁华茂[1] 张璐芳[1] 李华[1] 

机构地区：[1]北京大学第三医院妇产科,北京100191

出　　处：《中国微创外科杂志》2017年第11期1007-1010,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：国家自然科学基金(81572765)

摘　　要：目的探讨宫颈原发性小细胞癌的发病特点及诊治方案。方法回顾性分析2006年1月~2016年10月我院病理确诊的5例宫颈原发性小细胞癌的临床特征、治疗方案及预后。结果发病年龄28~53岁,中位年龄42岁。均有阴道异常出血。3例接受广泛子宫切除、双附件切除、盆腔淋巴结清扫术,1例接受广泛子宫切除、盆腔淋巴结清扫术,1例因术前诊断为子宫内膜小细胞癌接受子宫内膜癌分期术。均接受术后化疗,联合术后放疗3例。随访至2016年12月,3例无瘤生存,分别随访34、34和68个月;2例死亡,均有淋巴结转移,生存期分别为22和31个月。结论宫颈原发性小细胞癌无特征性临床表现,确诊主要依靠组织病理学检查。Ⅰb2期即可发生脉管及淋巴结转移,且淋巴结转移可提示预后不良。早期诊断、治疗对于改善预后有重要意义。联合手术与化放疗,对Ⅰb1期及无盆腔淋巴结转移的Ⅰb2期疗效较好。Objective To explore the clinical characteristics,diagnosis and therapy for primary cervical small cell carcinoma.Methods A total of 5 patients diagnosed as primary cervical small cell carcinoma between January 2006 and October 2016 in our hospital were enrolled. Clinical features,therapies and prognosis were retrospectively evaluated. Results The onset ages of these patients were 28-53 years old（median,42 years old）. All the patients suffered abnormal vaginal bleeding. Among the 5 patients,3 patients received radical hysterectomy, excision of bilateral accessory and pelvic lymphadenectomy,1 patient received radical hysterectomy and pelvic lymphadenectomy,and 1 patient received endometrial cancer cytoreductive surgery. All the patients received chemotherapy after surgery,and 3 patients received radiotherapy after surgery. Up to December 2016,there was no loss of follow-up cases. Three patients survived without tumor recurrence after 34,34,and 68 months,respectively. Two patients with lymphatic metastasis died,with the survival time of 22 and 31 months,respectively. Conclusions Primary cervical small cell carcinoma has no specific clinical features,and its diagnosis is mainly based on histopathological examinations. Lymphatic metastasis can happen inⅠb2 phase patients,which is a signal for poor prognosis. It＇s vital to provide early diagnosis and treatment for clinical benefit.Surgery combined with chemotherapy and radiotherapy is effective for Ⅰ b1 phase patients and lymphatic-metastasis-negative Ⅰ b2 phase patients.

关 键 词：宫颈肿瘤 小细胞癌 联合治疗 预后 

分 类 号：R737.33[医药卫生—肿瘤]