原发性宫颈小细胞癌临床病理分析

Primary Small Cell Carcinoma of Cervix:A Clinicopathologic Analysis of 5 Cases

目的探讨原发性宫颈小细胞癌的临床病理特征、免疫表型和生物学行为。方法采用光镜、免疫组化对5例宫颈小细胞癌进行观察、随访,并复习相关文献。结果 5例宫颈小细胞癌中单纯小细胞癌3例,合并腺癌或鳞癌2例。临床表现为不同程度的阴道不规则出血伴宫颈肿物。组织学显示肿瘤细胞小而圆,胞质少,核染色质深染,核仁不明显,分裂相活跃。免疫组化:5例肿瘤细胞CK和Syn+,3例CgA+,3例HPV+,4例NSE+。随访3例死亡。结论宫颈小细胞癌是一种罕见的高度恶性肿瘤,具有独特的病理形态特征。其发生可能与HPV感染有关,CK、CgA和Syn是较为特殊的免疫标记物。

Objective To investigate the clinicopathological features,immunohistochemical characteristics of small cell carcinoma of the cervix（SCCC）and its behaviour.Methods Five cases of SCCC were investigated with light microscopy and immunohistochemical staining.Clinical follow up was performed,and the related literature was reviewed.Results Blood spotting or abnomal vaginal blooding with cervical masses was the most common clinical presentation.Histologically,the neoplastic cells appeared small,round in solid sheets,scant cytoplasm,hyperchromatic neclei and absence of nucleoli.Numerous mitotic figures and extensive necrosis were also common findings.Three of five cases were pure small cell carcinoma.The foci of squamous cell carcinoma or adenocarcinoma were identified in two cases.Immunohistochemically,the tumors were immunoreactive to CK and Syn（five cases）,CgA and HPV（three cases）,NSE（four cases）,S-100（two cases）.Fellow up revaled death in all four patients.Conclusions Primary small cell carcinoma of the cervix is a rare and highly malignant tumor with distinct pathological features.Immunohistological staining may be helpful in diagnosis of SCCC.CK,CgA and Syn may be useful markers in the diagnosis of primary small cell carcinoma of the cervix.