早期宫颈小细胞神经内分泌癌84例临床分析  

Clinical Analysis on 84 Cases of Small Cell Neuroendocrine Carcinoma of Uterine Cervix in Early-Stage Disease

作　　者：刘超霞 张克强 桂玲 冉晓敏 肖凌志 LIU Chaoxia;ZHANG Keqiang;GUI Ling;RAN Xiaomin;XIAO Lingzhi(Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine,Central South University,Changsha,Hunan,410013,China)

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》2020年第6期734-740,共7页Anti-Tumor Pharmacy

摘　　要：目的探讨早期(ⅠA2-ⅡA2)宫颈小细胞神经内分泌癌(SCNECC)患者的临床病理特征及治疗方法,并分析其预后影响因素。方法收集2011年4月—2018年8月我院妇瘤科收治的84例早期SCNECC手术患者的临床资料,回顾性分析其生存及复发情况,并探讨相关预后影响因素。结果随访截止时间为2019年9月30日,中位随访时间37个月(8~101个月),其中有1例外省患者失访,随访期内死亡29例。患者3年和5年累积总生存率分别为66.1%和53.0%,3年和5年累积无进展生存率分别为55.7%和51.4%。随访期内共38例患者出现复发、转移,中位复发、转移时间为11个月(1~68个月);其中,盆腔复发11例、肺转移2例、肝转移2例、脑转移2例、骨转移及肾上腺转移各1例,其余19例均为多发性转移(转移部位≥2个)。单因素分析结果显示,术后是否化疗及化疗疗程(≥4次)与患者预后显著相关(P<0.05),而年龄、肿瘤直径、宫颈深间质受侵、淋巴血管间隙受累(LVSI)、盆腔淋巴结转移、新辅助化疗、手术方式、肿瘤成分(单纯型癌和混合型癌)及化疗方案与预后均无明显相关性(P>0.05);多因素分析结果显示,宫颈深肌层浸润、术后是否化疗、化疗疗程(≥4次)与预后显著相关(P<0.05)。结论早期SCNECC患者预后较差,术后补充化疗且化疗疗程≥4次可能是改善患者预后的有效方法。Objective To investigate the clinicopathologic characteristics,therapy and prognosis of patients with FIGO stageⅠA2-ⅡA2 small cell neuroendocrine carcinoma of the cervix(SCNECC).Methods Eighty-four cases of SCNECC in stageⅠA2-ⅡA2 treated at Hunan Cancer Hospital between Apr.2011 and Aug.2018 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 Sept.30,2019.The median follow-up time was 37 months(8~101 months).Twenty-nine patients died during the follow-up period,and one was lost for follow-up.The cumulative overall survival(OS)of 3 and 5 years were respectively 66.1%and 53.0%.The cumulative progressionfree survival(PFS)of 3 and 5 years were respectively 55.7%and 51.4%.A total of 38 cases had recurrence or metastases,and the median recurrence and metastases time was 11 months(range 1~68 months).The recurrent or metastatic sites were as follow:11 cases in pelvis,2 cases in liver,2 cases in lung,2 cases in brain,1 case in bones and 1 case in adrenal glands.The other 19 patients all had metastasis in two or more organs.The univariate analysis showed that postoperative chemotherapy and courses of chemotherapy(≥4)were significant prognostic factors(P<0.05),while age,lesion size,deep stromal invasion(DSI),lymph-vascular space invasion(LVSI),pelvic lymph node metastasis,neoadjuvant chemotherapy,surgery approach,tumor components(simplex carcinoma or hybrid),chemotherapy regimens were not significantly associated with prognosis(P>0.05).The multi-factor analysis showed deep stromal invasion,postoperative chemotherapy and courses of chemotherapy(≥4)were all significantly associated with prognosis(P>0.05).Conclusion Patients with early stage SCNECC yet had poor prognosis.Postoperative chemotherapy and courses of chemotherapy(≥4)may

关 键 词：宫颈肿瘤 小细胞神经内分泌癌 预后 

分 类 号：R737.33[医药卫生—肿瘤]