25例子宫颈神经内分泌癌患者临床病理分析  

Clinicopathological analysis of 25 cases with cervical neuroendocrine carcinoma

作　　者：李璐 邓茜 王淑妍 蒙伶俐 俞文英 LI Lu;DENG Xi;WANG Shu-yan;MENG Ling-li;YU Wen-ying(Ningbo Clinical Pathology Diagnosis Center,Ningbo,Zhejiang 315021,China)

机构地区：[1]宁波市临床病理诊断中心,浙江宁波315021

出　　处：《中国卫生检验杂志》2022年第9期1099-1102,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨原发性子宫颈神经内分泌癌的临床病理学特征、诊断及鉴别诊断。方法收集25例原发性子宫颈神经内分泌癌,分析其临床病理学及免疫表型特征。结果25例患者年龄为21岁~81岁,中位年龄为47岁。临床表现为不规则阴道出血或宫颈占位。3例为活检,2例行全子宫双附件切除,20例行广泛子宫切除及盆腔淋巴结清扫。光镜下肿瘤具有岛状、梁状、弥漫片状等神经内分泌肿瘤特征性结构,并表达CD56(19/25)、CgA(19/25)、Syn(23/25)、P16(21/25)、CKpan(20/20),Ki-67增殖指数为60%~95%。其中小细胞神经内分泌癌13例,复合性小细胞神经内分泌癌10例(合并腺癌9例,合并鳞癌1例),大细胞神经内分泌癌2例。22例随访1个月~60个月,6例于确诊3年内死亡,1例失访。结论原发性子宫颈神经内分泌癌较少见,预后差,推荐对所有期别患者进行多模式治疗以提高患者生存率。Objective To investigate the clinicopathological features,diagnosis and differential diagnosis of primary neuroendocrine carcinoma of the cervix.Methods The clinicopathological and immunophenotypic characteristics of 25 cases of primary cervical neuroendocrine carcinoma were collected,and the related literatures were reviewed.Results Twenty-five patients ranged in 21-81 years old,with a median age of 47.The clinical manifestations are irregular vaginal bleeding or cervical occupying.Three patients underwent biopsy,two underwent total hysterectomy and double adnexectomy,and 20 underwent extensive hysterectomy and pelvic lymph node dissection.Under light microscopy,the tumor showed characteristic neuroendocrine tumor structures such as island,beam and diffuse sheet,and expressed CD56(19/25),CgA(19/25),Syn(23/25),P16(21/25),CKpan(20/20).Ki-67 proliferation index was 60%-95%.There were 13 cases of small cell neuroendocrine carcinoma,10 cases of complex small cell neuroendocrine carcinoma(9 cases complicated with adenocarcinoma,1 case complicated with squamous cell carcinoma),and 2 cases of large cell neuroendocrine carcinoma.Twenty-two patients were followed up for 1 to 60 months,6 died within 3 years after diagnosis,and 1 lost to follow-up.Conclusion Primary neuroendocrine carcinomais a rare malignant in the cervix and has a poor prognosis.Multimodal therapy is recommended for all stages to improve patient survival.

关 键 词：宫颈肿瘤 小细胞癌 神经内分泌肿瘤 病理特征 

分 类 号：R737.33[医药卫生—肿瘤]