喉神经内分泌癌九例临床病理分析

Clinicopathologic study of 9 patients with neuroendocrine carcinoma of the larynx

目的总结喉神经内分泌癌患者的临床表现、治疗方法及预后。方法回顾性分析2005年5月至2011年6月共收治9例喉神经内分泌癌患者的临床资料，男6例，女3例；年龄35-65岁，中位年龄58岁。结果治疗方法采取单纯手术5例，手术加术后放化疗4例。2例喉典型类癌患者随访28、30个月未复发；3例喉不典型类癌患者，其中1例在随访至36个月时复发，再次手术后已随访30个月，未见局部复发及远处转移，另2例分别随访15、20个月，均未复发；3例喉小细胞神经内分泌癌患者，1例随访18个月仍存活，另2例分别于术后11及14个月死亡；喉副神经节瘤1例，随访32个月未复发。结论喉神经内分泌癌诊断有赖于临床特点、组织病理学及免疫组化检查。本病并无统一治疗方案，不同病理亚型的治疗方法及预后不同，对恶性程度较高的亚型主张采取以手术为主的综合治疗方案。

Objective To evaluate the clinic manifestation, therapy and prognosis of neuroendocrine carcinoma of the larynx. Methods Nine cases with neuroendocrine carcinoma of the larynx treated between May 2005 and June 2011 were analyzed retrospectively. Results There were six males and three females, with a median age of 58 years （ranging from 35 to 65 years）. Five cases were treated by only operation, and four cases by combined treatment （ surgery followed by radiotherapy and chemotherapy）. Two patients with typical carcinoid tumor had not any recurrence with following up of 28 and 30 months, respectively. Of three patients with atypical carcinoid tumor, one patient recurred in 36 months after the first operation and followed by re-operation, with no recurrence by further 30 month follow-up, and the other two patients did not recur 15 and 20 month follow-up, respectively. Of three patients with small cell neuroendocrine carcinoma, two died after 11 and 14 months, respectively, and another patient was followed up for 18 months, with no recurrence. One patient with paraganglioma showed no recurrence with a follow up of 32 months. Conclusions Neuroendocrine carcinoma in larynx included typical carcinoid tumor, atypical cacinoid tumor, small cell neuroendocrine carcinoma and paraganglioma. Accurate diagnosis relies on histopathologic and immunohistoehemical examination. There is no standard treatment plan and based- surgery combined treatment should be adopted to laryngeal neuroendocrine carcinoma. The prognosis is deoendent on tumor tvnes.