喉神经内分泌癌临床分析

Clinical analysis of 6 cases with neuroendocrine carcinoma of the larynx

目的探讨喉神经内分泌癌的诊断、治疗及预后情况。方法回顾性分析重庆医科大学附属第一医院耳鼻咽喉科2006年~2012年收治的6例喉神经内分泌癌患者的临床资料。结果随访时间3~54个月。1例典型类癌就诊时发现颈椎转移,未治疗随访13个月后死亡;2例非典型类癌,1例手术联合放化疗治疗后23个月未见复发转移,另1例单纯放疗后34个月后出现局部复发,行手术挽救性治疗后20个月肺转移及骨转移;3例小细胞神经内分泌癌,1例行放化疗后10个月局部复发,手术挽救性治疗后5个月远处转移死亡,另2例行放化疗后4个月及17个月远处转移死亡。结论喉神经内分泌癌很少见,预后差,极易复发转移,治疗方式及预后情况与喉神经内分泌癌病理亚型密切相关。

OBJECTIVE To summarize the clinical features, diagnosis,treatment and prognosis of laryngeal neu roendocr i ne ca rci noma( LNC).M ETHODS T he clinical data of 6 cases with LNC treated in our hospital between 2006 and 2012 were analyzed retrospectively.RESULTS All of the 6 patients had finished the followup from 3-54 months. One patient with typical carcinoid c a r ci nom a who h a d c e r v ic a l ve r t e b r a me t a s t a s e s at presentation refused to any treatment and died after 13 months. Of 2 patients with atypical carcinoid carcinoma, one patient recurred in 34 months after radiotherapy alone and followed by salvage surgery, with lung and bone metastases by further 20 months follow-up. Another patient did not recur 23 months follow-up after combined therapy(surgery followed by radiotherapy and chemotherapy).Another 3 patients with small cell neuroendocrine carcinoma,2 died 4 and 17 months respectively. Another patient recurred in 10 months after radiochemotherapy and followed by salvage surgery,died after 5 months with liver and adrenal glands metastases. CONCLUSION LNC is rare, but distant metastasis is common and the prognosis is poor. There is no standard treatment regimen and surgery-based combined therapy should be adopted to LNC.