14例宫颈小细胞神经内分泌癌临床病理分析

Small cell neuroendocrine carcinoma of the cervix:A clinicopathological analysis(14 cases)

目的:探讨宫颈小细胞神经内分泌癌的临床病理特征、诊断与鉴别。方法:通过回顾性方法收集2015年1月至2017年12月共14例宫颈小细胞神经内分泌癌。分析其临床特点、病理形态特征和免疫组化标记。结果:最常见的临床表现是接触性阴道流血流液、不规则阴道流血、腹部包块、隐痛。体格检查最常见为宫颈糜烂、宫颈肥大和萎缩。光学显微镜检查:细胞较小,大小不一,分散分布在间质血管周围,圆形或者梭形,胞浆较少而核染色较深,粗颗粒状,核仁不明显或者无核仁,核分裂象多见甚至有坏死。免疫组化检测:PCK(+)、EMA(+)、CGA(+)、CD45(-)、CD56(+)、CK8/18(+)、SYN(+)、NSE(+)、Ki-67(+,80%~95%)。结论:宫颈小细胞神经内分泌癌确诊需联合组织病理学及免疫组织化学检查,其恶性程度高,预后差,易复发,准确的病理诊断对临床治疗具有重要的作用。

Objective:To investigate the clinicopathological features,diagnosis and differential diagnosis of small cell neuroendocrine carcinoma of the cervix.Methods:14 cases of cervical small cell neuroendocrine carcinoma were retrospectively analyzed.Results:Clinical features included contact vaginal bleeding,irregular vaginal bleeding,abdominal mass and dull pain.Cervical erosion,cervical hypertrophy and atrophy were found in physical examination.The histopathological features showed that the cells were small size and different form,round or spindle shaped,coarsely granular,with less cytoplasm and deeper nucleus dyeing,which scattered around the interstitial vessels.Mitosis was commonly found in these cases,and necrosis was also be seen in some cases.Immuohistoch emistry showed PCK(+),EMA(+),CGA(+),CD45(-),CD56(+),CK8/18(+),SYN(+),NSE(+),Ki-67(+,80%~95%).Conclusion:Histopathological examination combined with immunohistochemical analysis,is helpful to the accurate diagnosis of small cell neuroendocrine carcinoma of the cervix.It is a highly malignant tumor with high recurrence and poor prognosis.Accurate pathological diagnosis plays an important role in clinical treatment.