子宫颈神经内分泌癌12例临床病理分析

Clinical and pathological analysis of 12 cases of the neuroendocrine carcinoma of uterine cervix

目的:分析子宫颈原发性神经内分泌癌的临床病理特点,探讨有效的诊治方法,以期改善预后。方法:回顾分析2003年至2007年收治的12例原发于子宫颈的神经内分泌癌的临床资料。结果:12例患者平均年龄37岁,均行手术治疗,术前化疗3例,术后化疗2例,放疗4例,同期放化疗4例,术后发现淋巴结转移4例,脉管浸润10例。随访10例中死于复发1例(IB期),出现肝脏转移但存活1例(IB期),无瘤生存8例。结论:子宫颈神经内分泌癌恶性度高,易早期转移,短期复发且复发后对后续治疗可能抵抗,其治疗多采取手术及放化疗联合治疗,目前尚无有效的成熟方案,预后差。

Objective：To investigate the clinical and pathological characteristics of patients with the primary neuroendocrine carcinoma of uterine cervix, and explore an efficient treatment in order to improve the prognosis. Methods：The clinical data of 12 patients with primary neuroendocrine carcinoma of uterine cervix from 2003 to 2007 were analysed retrospectively. Results：The mean age of the patients was 37 years, all cases received surgery, with 3 cases of preoperative adjuvent chemotherapy,2 cases of postoperative chemotherapy,4 cases of radiation therapy and 4 cases of radio-chemotherapy. Four cases were found with lymph nodes involvement,10 cases with vessel invasion. Among the 10 cases followed up, 1 case died of relapse, 1 survived with liver metastasis and 8 survived without evidence of relapse. Conclusion： The neuroendocrine carcinoma of uterine cervix is highly malignant and tends to metastases and relapse early, resists to the subsequent treatment after relapse. The combined therapy based on operation ,chemotherapy and radiation is adopted, while the desire of an efficient established treatment is still urgent because of the poor prognosis.