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作 者:黄卓雅[1] 刘英霞[2] 王秀平[1] 廖鹏娟 钟鸣[2] 苏桂晓 王晓冰[1] 赵文丽[2] HUANG Zhuoya;LIU Yingxia;WANG Xiuping;LIAO Pengjuan;ZHONG Ming;SU Guixiao;WANG Xiaobing;ZHAO Wenli(Huizhou Municipal Central Hospital,Huizhou 516001,China;不详)
机构地区:[1]惠州市中心人民医院,广东惠州516001 [2]惠州市第一人民医院
出 处:《中外医学研究》2020年第24期182-185,共4页CHINESE AND FOREIGN MEDICAL RESEARCH
基 金:惠州市医疗卫生类科技计划项目(2019Y030)。
摘 要:目的:分析宫颈神经内分泌癌的临床及病理特征,进一步揭示其生物学本质,为正确的病理诊断提供科学证据。方法:收集惠州市中心人民医院及惠州市第一人民医院2008年1月-2019年12月诊断原发性宫颈神经内分泌癌患者共10例,分析其临床、病理特征,采用免疫组化方法确定其神经内分泌标记物表达特征并进行随访。病理切片由3位病理医生独立评估。结果:10例患者年龄33~78岁,中位年龄47岁,平均年龄(50.1±15.1)岁。9例小细胞型,1例大细胞型;8例单纯性,2例混合性。1例液基细胞学提示阳性结果。1例二代测序检测出携带体细胞突变。免疫组化染色癌细胞CK阳性率100%(9/9),Ki67增殖指数60%~90%。神经内分泌标记物Syn、CgA、NSE、CD56阳性率分别为90.0%(9/10)、55.6%(5/9)、83.3%(5/6)、85.7%(6/7),癌细胞CK阳性率最高。获得随访资料3例患者均发生远处转移,最常见转移部位胰腺、肝脏。结论:宫颈神经内分泌癌病理类型以单纯性小细胞型最常见,正确诊断基于HE及免疫组化染色,液基细胞学检查可有阳性发现但诊断价值有限。宫颈神经内分泌癌是一组罕见而高度恶性肿瘤,远处转移常见,预后差,除放化疗外还需更加个体化的靶向精准治疗。Objective:To analyze the clinical and pathological features of cervical neuroendocrine carcinoma,further reveal its biological essence and provide scientific evidence for correct pathological diagnosis.Method:A total of 10 patients with primary cervical neuroendocrine carcinoma diagnosed in Huizhou Central People’s Hospital and Huizhou First People’s Hospital from January 2008 to December 2019 were collected.The clinical and pathological features were analyzed,and the expression characteristics of neuroendocrine markers were determined by immunohistochemical method and followed up.The biopsies were evaluated independently by 3 pathologists.Result:The 10 patients aged 33~78 years,with a median age of 47 years and an average age of(50.1±15.1)years,9 cases were small cell type and 1 case was large cell type,8 cases were simple and 2 cases were mixed.Liquid-based cytology indicated a positive result in 1 case.One case of somatic cell mutation was detected by second-generation sequencing.Immunohistochemical staining showed CK positive rate of 100%(9/9)and Ki67 proliferation index of 60%~90%.The positive rates of neuroendocrine markers Syn,CgA,NSE and CD56 were 90.0%(9/10),55.6%(5/9),83.3%(5/6)and 85.7%(6/7),respectively,with the highest positive rates of CK.During the follow-up period,3 patients suffered from recurrence and metastasis,the most common metastatic location was pancreas and liver.Conclusion:Pure small cell type is the most common type of cervical neuroendocrine carcinoma in pathogy.The effective diagnosis is based on HE and immunohistochemical staining.Liquid-based cytology might be positive but the diagnostic value was quite limited.Cervix neuroendocrine carcinoma is a very rare but trulyaggressive disease,that requires an individualized multidisciplinary management.
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