喉神经内分泌癌的临床研究

Clinical analysis of neuroendocrine carcinoma of the larynx

目的:探讨喉神经内分泌癌的临床表现、诊断、治疗及预后。方法:回顾性分析病理确诊为喉神经内分泌癌的26例患者的临床资料,典型类癌1例,不典型类癌15例,神经内分泌型小细胞癌9例,混合性神经内分泌型小细胞癌1例。12例行全喉切除术、2例行喉环状软骨上部分切除环舌骨固定术、4例行喉水平部分切除术、5例行喉垂直部分切除术、1例行经口CO_2激光喉显微手术、2例单纯接受放/化疗。结果:3年、5年总体生存率分别为76.9%和69.2%。结论:喉神经内分泌癌临床罕见,临床表现无特异性,其中不典型类癌最常见,病变以声门上区多见,各病理亚型的生物学行为、治疗及预后差别较大,确诊需全面的免疫组织化学检测。

Objective：To evaluate the clinical manifestation,therapy and prognosis of neuroendocrine carcinoma of the larynx.Method：Twenty-six cases with neuroendocrine carcinoma of the larynx were analyzed retrospectively.Four pathological types were found in our series：typical carcinoid（1/26）,atypical carcinoid（15/26）,small cell carcinoma,neuroendocrine type（9/26）and combined small cell carcinoma,neuroendocrine type（1/26）.In this series,12 cases were received total laryngectomy,2 cases supracricoid partial laryngectomy-cricohyoidopexy（SCPL-CHP）,4 cases horizontal partial laryngectomy,5 cases vertical partial laryngectomy,1 case transoral CO_2 laser microsurgery,and 2 cases radiotherapy and/or chemotherapy.Result：Three-year and five-year overall survival rates were 76.9% and 69.2% respectively.Conclusion：The neuroendocrine carcinoma of the larynx was rare,which was more common in the supraglottis.Atypical carcinoid was the most common pathological type.Compared to SCC,the clinical feature of neuroendocrine carcinoma of the larynx was non-specific.The clinical behavior,treatment,and prognosis were correlative to the tumor pathological.The diagnosis depended on comprehensive immunohistochemistry examination.