子宫颈小细胞神经内分泌癌临床病理分析

Clinical pathological analysis of small cell neuroendocrine carcinoma of the cervix

目的探讨宫颈小细胞神经内分泌癌(small cell neuroendocrine carcinoma of the cervix,SCNEC)的临床病理特征和免疫组化特点。方法对四川省妇幼保健院病理科和四川省人民医院病理科2006年1月至2014年6月诊治的8例宫颈小细胞神经内分泌癌进行组织形态学、免疫组化观察,并对其临床资料进行整理分析。结果 8例患者平均年龄45.6岁,均以阴道不规则出血或宫颈接触性出血就诊。组织学显示肿瘤由大小较为一致的圆形、卵圆形细胞构成。其中单纯性小细胞神经内分泌癌7例,合并腺癌成分1例。免疫组化:所有病例癌细胞细胞角蛋白(CK)不同程度阳性,且均有两种以上神经内分泌标记阳性,其中6例突触素(Syn)和嗜铬素(Cg A)均阳性,4例神经细胞黏附分子(CD56)阳性。随访7例患者,死亡3例。结论宫颈小细胞癌作为一种少见的高度恶性肿瘤,进展快,预后差,免疫组化神经内分泌标志阳性有助于诊断。

Objective To investigate the histopathologic and immunohistochemical characteristics of small cell neuroendocrine carcinoma （SCNEC） in the cervix.Methods Morphologic and immunohistochemical techniques and related clinical data of 8 cases with small cell neuroendocrine carcinoma of the cervix （SCNEC） in Department of pathology, Sichuan Provincial Hospital for Women and Children and Sichuan Academy of Medical Sciences＆amp;Sichuan Provincial People’ s Hospital were analyzed .Results The average of 8 cases age was 45.6 years old, and the main symptoms were vaginal bleeing or cervical contactive bleeding .Microscopically, all tumors were composed of small -sized cells in uniformity .7 cases were pure SCNEC , 1 case accompanied with adenocarcinoma . Immunohistochemically , all the tumors were positive to CK , 6 cases were positive to Syn and CgA , and 4 cases were positive to CD56. Follow-up revealed death in 3 cases.Conclusion SCNEC is a rare malignant tumor in the cervix .It is aggressive with a poor prognosis.Immunohistological staining is helpful in diagnosis of SCNEC.