子宫颈小细胞癌的临床及病理分析

Clinicopathologic Study of Patients with Small Cell Carcinoma of the Cervix

目的 探讨子宫颈小细胞癌的临床病理特征、诊断和治疗。方法 回顾性分析 8例子宫颈小细胞癌的临床记录和随访资料。结果 8例均表现为不同程度的阴道排液增多。病理学特点为大小形态一致的圆形或短梭形小细胞 ,弥漫性浸润间质 ,符合宫颈小细胞癌的病理学诊断 ;2例神经元特异性烯醇化酶免疫组织化学染色阳性。 8例中 ,Ⅰb期 5例 ,Ⅱb期 3例。 7例接受了广泛子宫切除及盆腔淋巴结清扫术治疗 ,1例Ⅱb期患者仅接受了放射治疗。 7例手术病例中 ,3例发现盆腔淋巴结转移。 4例患者分别无瘤存活 2、13、16和 2 5个月。 4例死亡患者的生存期分别为 4、5、7和 10个月 ,其中 1例仅为接受放射治疗者 ,1例为宫颈巨大肿瘤者 ,另 2例为盆腔淋巴结转移者。结论 宫颈小细胞癌早期易发生盆腔淋巴结转移 ,对早期病例 ,应采用广泛子宫切除及盆腔淋巴结清扫术 ,术后进行放射治疗或化学治疗。

Objective To study the clinicopathologic characteristics,diagnosis and treatment of small cell carcinoma of the cervix. Methods Eight patients with small cell carcinoma of the cervix were treated from May 1991 to December 1997 at Jiangxi Women′s and Children′s Hospital. Clinical data and follow up crecords were retrospectively analyzed. Results Fivepatients had stage Ⅰ b disease and 3 had stage Ⅱ b disease. Seven patients underwent radical hysterectomy with pelvic lymph node dissection. One patient with stage Ⅱ b disease was only treated with radiotherapy. Of the patients treated with operation,three showed pelvic lymph node metastases. Four patients who are alive free of the disease have been followed for 2,13,16 and 25 months,respectively. The survival intervals of 4 patients who died of the disease was 4,5, 7 and 10 months,respectively. Of the death, one patient was only treated with radiotherapy, another had a very large cervical tumor and the two others complicated with pelvic lymph node metastases. Conclusions Small cell carcinoma of the cervix is an aggressive tumor with a potentiality for early pelvic lymph node metastases and rapid recurrence,It is associated with higher mortality than any other cervical malignant neoplasms. It is able to make a right diagnosis with a combination of histopathologic and immunohistochemical characteristics