宫颈大细胞神经内分泌癌诊治进展

Progress in Diagnosis and Treatment of Cervical Large Cell Neuroendocrine Carcinoma

宫颈大细胞神经内分泌癌(large cell neuroendocrine carcinoma,LCNEC)是一种特殊类型的宫颈癌,具有恶性程度高、侵袭性强等特征,早期即表现出全身转移倾向。宫颈LCNEC的发病与高危型HPV感染密切相关,因临床表现缺乏特异性,对其的诊断主要依靠典型的病理学特征及特异性神经内分泌标志物的检测。由于宫颈LCNEC的发病率低,病例资料有限,目前尚无标准化的诊疗方案,对其治疗主要借鉴于小细胞肺癌,以根治性手术联合化疗及放疗为主。但基因组数据表明,宫颈LCNEC在遗传学上与常见的宫颈癌类型更相似,而不是肺或膀胱等的宫颈外的小细胞神经内分泌癌,这对一些因肿瘤组织间具有相似形态学表现而采取相似治疗方案的思路提出了质疑。综述宫颈LCNEC的最新研究进展,以期为临床工作提供参考。

Cervical large cell neuroendocrine carcinoma(LCNEC)is a special type of cervical cancer with characteristics of high malignancy and aggressiveness,and shows a tendency to metastasize systemically at an early stage.The development of cervical LCNEC is closely related to high-risk HPV infection.The diagnosis of cervical LCNEC is mainly based on typical pathological features and detection of specific neuroendocrine markers because of the lack of specificity of clinical manifestations.Due to the low incidence of cervical LCNEC and limited case data,there is no standardized treatment protocol,and its treatment is mainly based on small cell lung cancer,with radical surgery combined with chemotherapy and radiotherapy.However,genomic data suggest that cervical LCNEC is genetically more similar to common types of cervical cancer rather than to small cell neuroendocrine carcinoma outside the cervix,such as lung or bladder,which questions the ideas of adopting similar treatment regimens because of similar morphological manifestations among tumor tissues.This article focuses on a review of recent research advances regarding cervical LCNEC,with the aim of providing references and lessons for clinical work.