喉神经内分泌肿瘤临床诊疗分析

Clinical Analysis of Patients with Laryngeal Neuroendocrine Neoplasm

目的探讨喉神经内分泌肿瘤(LNEN)患者的临床特点、治疗方法及预后。方法回顾性分析2015年8月至2022年4月在郑州大学第一附属医院就诊并经病理证实的19例LNEN患者的临床病例资料。结果19例患者中,男17例,女2例,年龄46~74岁,中位年龄62岁。神经内分泌瘤G11例,神经内分泌瘤G28例,小细胞神经内分泌癌10例。采用放化疗6例,手术联合放和/或化疗13例,其中11例患者接受开放性手术,2例接受经口微创CO_(2)激光手术。随访时间5~68个月,中位随访时间为22.5个月。患者中手术联合放化疗13例,其中7例无瘤生存至今,最长随访时间68个月;3例死亡;2例远处转移;1例失访。6例未接受手术治疗,其中4例死亡,2例随访治疗中。结论LNEN恶性程度高,早期易扩散转移,预后较差。精准的肿瘤临床分期及病理学分型是决定其治疗和预后的重要因素。以手术治疗为主,联合化疗和放疗的综合性治疗是首选方案。

Objective To investigate the clinical features,treatment methods and prognosis of laryngeal neuroendocrine neoplasm(LNEN).Methods From August 2015 to April 2022,the clinical data of 19 cases with LNEN confirmed by pathology in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed.Results There were 17 males and 2 females,with a median age of 62 years(ranging from 46 to 74 years)among the 19 patients.One case was neuroendocrine tumor G1,8 cases were neuroendocrine tumor G2,10 cases were small cell neuroendocrine carcinomas.Six cases were treated by radiotherapy and/or chemotherapy,and thirteen cases by combined treatment(surgery followed by radiotherapy and/or chemotherapy),among which 11 patients received partial or total laryngectomy,and 2 of them took CO 2 laser surgery.The follow-up period was 5-68 months,with a median follow-up period of 22.5 months.In 13 cases of surgery combined with radiotherapy and chemotherapy,7 cases had survived without tumor,and the longest follow-up time was more than 68 months,3 cases died,2 cases had distant metastasis,and 1 case lost follow-up.In 6 cases without surgical treatment,4 cases died,and 2 cases were in follow-up treatment.Conclusion LNEN are characterized by high malignancy,early metastasis and poor prognosis.Accurate clinical staging and pathological classification of tumors are important factors that determine their treatment and prognosis.Based-surgery combined treatment is the preferred treatment.