Primary Ovarian Small Cell Carcinoma of Pulmonary Type: Analysis of 6 Cases and Review of 31 Cases in the Literatures

Objective Primary ovarian small cell carcinoma of pulmonary type(SCCOPT)is a rare ovarian tumor with a poor prognosis.The platinum-based chemotherapy is the standard treatment.However,there is little research on the clinical characteristics of SCCOPT and the potential benefits of other treatments due to its low incidence.The study aims to investigate clinicopathological characteristics and treatment of SCCOPT.Methods We summarized the clinical,imaging,laboratorical and pathological characteristics of 37 SCCOPT cases,in which 6 cases were admitted to the Gansu Provincial Hospital from the year of 2008 to 2022 and 31 cases reported in 17 English and 3 Chinese literatures.Results The median age of the studied SCCOPT cases(n=37)was 56.00(range,22-80)years.Almost 80%of them had a stageⅢorⅣtumor.All patients underwent an operation and postoperative chemotherapy.Nevertheless,all cases had a poor prognosis,with a median overall survival time of 12 months.Immunohistochemical y,the SCCOPT of all patients showed positive expressions of epithelial markers,such as CD56 and sex-determining region of Y chromosome-related high-mobility-group box 2(SOX-2),and negative expressions of estrogen receptor,progesterone receptor,vimentin,Leu-7,and somatostatin receptor 2.The tumor of above 80%cases expressed synaptophysin.Only a few cases expressed neuron-specific enolase,chromogranin A,and thyroid transcription factor-1.Conclusions SCCOPT had a poor prognosis.SOX-2 could be a biomarker to be used to diagnose SCCOPT.

Development and validation of a prognostic nomogram model for Chinese patients with primary small cell carcinoma of the esophagus

BACKGROUND Primary small cell carcinoma of the esophagus(PSCE)is a highly invasive malignant tumor with a poor prognosis compared with esophageal squamous cell carcinoma.Due to the limited samples size and the short follow-up time,there are few reports on elucidating the prognosis of PSCE,especially on the establishment and validation of a survival prediction nomogram model covering general information,pathological factors and specific biological proteins of PSCE patients.AIM To establish an effective nomogram to predict the overall survival(OS)probability for PSCE patients in China.METHODS The nomogram was based on a retrospective study of 256 PSCE patients.Univariate analysis and multivariate Cox proportional hazards regression analysis were used to examine the prognostic factors associated with PSCE,and establish the model for predicting 1-,3-,and 5-year OS based on the Akaike information criterion.Discrimination and validation were assessed by the concordance index(C-index)and calibration curve and decision curve analysis(DCA).Histology type,age,tumor invasion depth,lymph node invasion,detectable metastasis,chromogranin A,and neuronal cell adhesion molecule 56 were integrated into the model.RESULTS The C-index was prognostically superior to the 7th tumor node metastasis(TNM)staging in the primary cohort[0.659(95%CI:0.607-0.712)vs 0.591(95%CI:0.517-0.666),P=0.033]and in the validation cohort[0.700(95%CI:0.622-0.778)vs 0.605(95%CI:0.490-0.721),P=0.041].Good calibration curves were observed for the prediction probabilities of 1-,3-,and 5-year OS in both cohorts.DCA analysis showed that our nomogram model had a higher overall net benefit compared to the 7th TNM staging.CONCLUSION Our nomogram can be used to predict the survival probability of PSCE patients,which can help clinicians to make individualized survival predictions.

The 2002 AJCC TNM classification is a better predictor of primary small cell esophageal carcinoma outcome than the VALSG staging system

Small cell carcinoma of the esophagus (SCCE) is a rare and aggressive malignant tumor with a poor prognosis. The optimal disease staging system and treatment approaches have not yet been defined. This study aimed to evaluate the prediction of different staging systems for prognosis and treatment options of SCCE. We retrospectively accessed the clinicopathologic characteristics, treatment strategy, and prognosis of 76 patients diagnosed with primary SCCE between 2001 and 2011. The 1-, 2-, 3-, and 5-year overall survival rates were 58%, 31%, 19%, and 13%, respectively. Univariate analysis showed that the 2002 American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) classification (P=0.002), Veterans Administration Lung Study Group (VALSG) stage (P=0.001), predisposing factors (P<0.001), T category (P=0.023), and M category (P<0.001) were prognostic factors for overall survival. Multivariate analysis showed that the 2002 AJCC TNM stage (P<0.001) was the only independent prognostic factor for survival. The value of the area under the receiver operator characteristic (ROC) curve (AUC) of the 2002 AJCC TNM staging system was larger than that of VALSG staging system with regard to predicting overall survival (0.774 vs. 0.620). None of the single treatment regimens showed any benefit for survival by Cox regression analysis. Thus, the 2002 AJCC TMN staging system improved the prediction of SCCE prognosis; however, the optimal treatment regimen for SCCE remains unclear.

Endoscopic diagnosis of early-stage primary esophageal small cell carcinoma: Report of two cases

BACKGROUND Primary esophageal small cell carcinoma(PESCC)is a highly aggressive malignancy,and its detailed clinical behaviors have remained virtually unknown.Because of the rapid tumor progression,the diagnosis of esophageal small cell carcinoma at early stage is extremely difficult in clinical practice.Currently,only a handful of PESCC cases have been reported.CASE SUMMARY Case 1:A 62-year-old man was diagnosed with an esophageal submucosal tumor by endoscopy.Endoscopic ultrasonography showed a 0.8 cm low echo nodule in the muscularis mucosa.As the patient refused to undergo endoscopic resection,neoplasia was detected by endoscopy 1 year later.Case 2:A 68-year-old woman was diagnosed as having an esophageal submucosal tumor by endoscopy at a local hospital.About 2 wk later,we performed endoscopic ultrasonography and found a 1 cm low echo nodule in the muscularis mucosa;the submucosal was thinner than normal but still continuous;mucosal hyperemia and erosion were found on the surface of the tumor.Endoscopic submucosal dissection(ESD)was performed and the histopathological finding showed a small cell carcinoma invading the submucosal layer.CONCLUSION Early esophageal small cell carcinoma shows submucosal infiltrating growth with a hypoechoic mass in the muscularis mucosa as diagnosed by endoscopic ultrasonography.It is easily misdiagnosed as submucosal masses.Endoscopic manifestations should be identified and pathological biopsies should beemployed. ESD may be performed to provide an opportunity for early treatmentof PESCC.

Diagnosis and treatment of primary small cell carcinoma of urinary bladder

Objective To investigate clinical and pathological features of small cell carcinoma of urinary bladder. Methods The pathological and clinical data of 9 cases of small cell carcinoma were analyzed retrospectively.

Primary small cell esophageal carcinoma,chemotherapy sequential immunotherapy:A case report

BACKGROUND Primary small cell esophageal carcinoma(PSCEC)is aggressive and rare,with a worse prognosis than other subtypes esophageal carcinoma.No definitive and optimum standard guidelines are established for treating it.Herein,we report a case of PSCEC,including a current literature review of PSCEC.CASE SUMMARY A 79-year-old male was diagnosed PSCEC with multiple lymph node metastasis thorough computed tomography,positron emission tomography-computed tomography,endoscopy and pathology.Surgery was not suitable for this patient.He was treated with etoposide 100 mg/m2 and cisplatin 25 mg/m2 on days 1-3,every 3 wk for 4 cycles.The tumor and lymph nodes became smaller and dysphagia and vomiting symptoms improved.The patient could not tolerate subsequent chemotherapy(CT)because of hematological toxicity;therefore,we performed immunotherapy(durvalumab,1500 mg)every 4 wk.At present the patient has received 12 cycles immunotherapy over about 1 year.He is still receiving treatment and follow-up.CONCLUSION PSCEC with multiple lymph nodes metastasis does not always indicate surgery.CT may extend survival time and improve the quality of life in the absence of surgery.Immunotherapy or immunotherapy plus CT may also work as a treatment for PSCEC.

Synchronous primary cancers of trachea and esophagus and ventricular tachycardia

The incidence of multiple primary cancers involving trachea is rare. We present a case of synchronous double primary cancer of trachea and esophagus in a 70-year-old woman, with a special symptom of ventricular tachycardia and no/a/story of smoking and alcohol drinking. Biopsies （tom multiple loci demonstrated the patient had primary small cell cancer of trachea and squamous cell carcinoma in situ of esophagus. The patient was successfully treated with four cycles of chemotherapy consisting of etoposide and earboplatin （EC） followed by thoracic radiotherapy （60 Gy in 30 fractions, in 6 weeks）, and was evaluated to have complete response of tumor. To our knowledge, there is no synchronous cancer of trachea and esophagus has been reported in English literature, and our experience showed sequential EC chemotherapy and radiotherapy provided an effective treatment to control both cancers.

Management of primary small cell carcinoma of the esophagus

Background Primary small cell carcinoma of the esophagus is rare. Although surgery is successful in eradicating local tumor, the five-year survival rate of patients with primary small cell carcinoma of the esophagus after resection is lower than that of patients with primary squamous cell carcinoma of the esophagus. The purpose of this study was to analyze the clinical manifestations, pathological features and treatment of primary small cell carcinoma of the esophagus. Methods A total of 73 patients with primary small cell carcinoma of the esophagus who had been treated by surgery from 1984 to 2003 were analyzed retrospectively. Results In this series, the overall resection rate was 94.5% （69/73）, the radical resection rate 89.0% （65/73） and the operative mortality 1.4% （1/73）. The 1-, 3- and 5-year survival rates of patients were 50.7%, 13.7% and 8.2%, respectively. Conclusions Primary small cell carcinoma of the esophagus is rare with a poor prognosis. Surgical resection is the leading method for patients with stage Ⅰ or Ⅱ primary small cell carcinoma of the esophagus. Postoperative chemotherapy is beneficial to these patients. The patients of stage Ⅲ or IV should be given chemotherapy and radiation therapy.

155例原发性食管小细胞癌的预后分析

目的:回顾性分析原发性食管小细胞癌(primary small carcinoma of esophagus,PSCCE)患者的临床病理学特征及治疗模式,探索影响患者预后的因素,希望为该病的临床治疗及预后评价提供参考依据。方法:回顾性分析2006年01月至2020年06月我院收治的经病理学诊断为PSCCE的患者,资料包括年龄、性别、基础疾病、癌症家族史、吸烟史、饮酒史、原发灶浸润深度、部位、淋巴结转移、远处转移、是否合并肝转移、手术后病理是否存在神经侵犯或脉管癌栓、治疗模式,并进行随访。采用Kaplan-Meier生存曲线分析患者总生存期(overall survival,OS),采用Log-rank进行单因素分析,利用COX比例风险回归模型进行多因素分析,探索影响PSCCE患者生存的独立预后因素,通过亚组分析筛选最佳的治疗模式。结果:155例纳入该研究的PSCCE患者的中位发病年龄为65.8岁,男女比例为1.18∶1.00,中位生存时间为15个月,1年和3年生存率分别为63.2%和13.5%。单因素分析显示,影响OS的因素包括年龄、伴脉管癌栓/神经侵犯阳性、首诊时食管浸润深度、首诊时淋巴结转移情况、首诊时远处转移情况、治疗模式、合并肝转移。多因素分析结果显示,影响OS的独立危险因素有淋巴结转移(HR=2.492,95%CI:1.579~3.933,P<0.001)、合并肝转移(HR=1.978,95%CI:1.230~3.448,P=0.005);保护因素为T_(1)(T_(1)vs T_(3-4),HR=0.541,95%CI:0.301~0.976,P=0.041)和综合治疗模式(P<0.001)。结论:回顾性研究表明早期诊断、综合治疗模式可能改善PSCCE患者的预后,合并淋巴结转移、合并肝转移PSCCE患者预后较差。

Primary Squamous Cell Carcinoma of the Small Intestine： Pathogenesis and Clinical Features

Relative to the length and surface area of the gastrointestinal tract, malignant tumors of the small intestine are remarkably rare, with a global incidence of〈1 per 100,000 population. Among the forty different histological subtypes of small intestinal cancers, primary squamous cell carcinoma （SCC） is exceptionally rare with only occasional case reports in literature. The present study reported a case of primary SCC of the small intestine and reviewed all cases reported in English literature to provide a systematic overview of this rare disease.

以小细胞神经内分泌癌和鳞癌为表现的同时同叶双原发肺癌1例

多原发性肺癌(MPLC)是一种较为罕见的肺癌类型,小细胞肺癌及非小细胞肺癌同时存在于同一肺叶的MPLC更为罕见。我们报道一例63岁男性,既往无吸烟史,无恶性肿瘤家族史,在左肺上叶同时发现两个结节,一个结节以分叶状为特征,另一个以毛刺、空泡、胸膜牵拉为特征,术后病理提示小细胞神经内分泌癌和鳞癌,诊断为同时同侧同叶双原发肺癌(pT1bN0M0,IA2期),并对其CT特征进行分析,以提高临床医生对该病的认识。

原发性食管小细胞癌临床特征及预后分析

目的探讨食管小细胞癌的临床特征和预后。方法收集经食管吞钡片、胸部CT、食管镜检查并经病理学检查确诊的15例食管小细胞癌病例,分析患者的临床特征及预后。结果 15例患者的中位生存期为8.82个月(生存期29 d～26个月);6个月生存率为53%,1年生存率为20%,2年生存率为7%,3年生存率为零。接受单纯手术、单纯化疗和综合治疗患者的中位生存期分别为8、4.1和11.83个月。结论食管小细胞癌的最佳治疗方案尚不明确,以化放疗为主的综合治疗可获得较单一治疗更长的生存期。

食管小细胞癌的临床病理分析

目的:探讨食管小细胞癌的组织起源、生物学特性以及影响其预后的相关因素。方法:应用多种免疫组织化学检测的方法对63例食管小细胞癌进行了广谱细胞角蛋白(CK)、神经元特异性烯醇化酶(NSE)、嗜铬粒-A(CHr-A)、突触素(Syn)和CD56的检测。结果:63例食管小细胞癌,光镜下分为单一型小细胞癌(28/63)和混合型小细胞癌(35/63)。CK、NSE、CHr-A、Syn和CD56的阳性率分别为41.3%、36.5%、90.5%、60.3%和50.8%。5种抗体在单一型小细胞癌和混合型小细胞癌中的阳性表达情况比较(P>0.05),差别无显著性意义。影响预后的主要因素是肿瘤体积、浸润深度、残端(+)和瘤栓及淋巴结转移,与组织学类型及有无神经内分泌表达无关。结论:食管小细胞癌为高恶度肿瘤,对神经源性特异性抗体表达有明显的亲和性;其组织来源尚难定论,本研究倾向于非神经上皮源性。

原发性小细胞食管癌外科治疗预后分析

目的:探讨原发性小细胞食管癌外科治疗的预后。方法:回顾性分析2000年1月到2009年12月河南省肿瘤医院胸外科接受手术治疗的所有食管癌5 062例患者的临床资料。重点对其中确诊为原发性小细胞食管癌的患者的临床资料及随访结果进行分析,采用Kaplan-Meier法进行生存分析。结果:共57例患者确诊为原发性小细胞食管癌,占所有接受食管切除手术食管癌患者总数的1.1%。对病变位于胸中下段食管癌患者,绝大多数采用经左胸入路手术,对于病变位于胸上段者,采用经右胸入路,所有患者均接受食管胃颈部吻合。联合化疗最常用的化疗方案为EP方案。57例原发性小细胞食管癌患者,总体5年生存率12.5%,中位生存时间45个月,其中Ⅰ期分别为25%、50个月,Ⅱ期5.9%、43个月,Ⅲ期4.3%,43个月;单纯手术组中位生存时间明显低于手术联合化疗组(23.2个月vs.60.7个月,P<0.01)。即使对于Ⅰ期患者,手术联合化疗组患者中位生存时间也明显长于单独手术组(81.9个月vs.22.3个月,P<0.01)。结论:原发性小细胞食管癌单纯手术治疗效果不佳,手术联合化疗可明显提高疗效。

Survivin基因在食管小细胞癌中的表达及与caspase-3和p53蛋白表达的关系

探讨Survivin在食管小细胞癌中表达与细胞凋亡的意义以及与caspase-3和p53凋亡相关基因表达的相关性。方法:采用免疫组织化学SP法检测凋亡抑制基因Survivin、凋亡关键蛋白酶caspase-3和p53蛋白在食管小细胞癌中的表达。结果:Survivin在食管小细胞癌中阳性表达率为25.6%,caspase-3和p53阳性表达率为61.5%和53.8%。其中Survivin和caspase-3表达呈负相关,P<0.05,Survivin和p53表达以及与年龄、性别、浸润程度、淋巴结转移等无相关性。结论:1)在食管小细胞癌中凋亡抑制基因Survivin表达下调,凋亡蛋白酶caspase-3活性相对较高。2)p53表达和Survivin、caspase-3无相关性。

28例原发性食管小细胞癌外科疗效分析

目的探讨原发性食管小细胞癌的外科治疗效果。方法对28例接受手术治疗的原发性食管小细胞癌患者的疗效进行回顾性分析。结果按1997年新的国际食管癌TNM分期标准,Ⅰ期5例、Ⅱ期13例、Ⅲ期10例。手术后1、2、3年和5年生存率分别为50.0%、21.4%、10.7%、7.1%,最长生存者已达8年,中位生存期15个月。结论原发性食管小细胞癌恶性程度高、预后差,肿瘤的TNM分期仍是影响其疗效的重要因素。如何早期发现和对早期患者实施以手术为主的综合治疗是提高疗效的关键。

原发性食管小细胞未分化癌(附15例分析)

本文分析原发性食管小细胞未分化癌15例,发生率占同期收治食管癌2121例的0.71％。本病主要见于中老年男性,中位年龄57岁,男性11例,女性4例。吞咽困难是最常见的症状,中位症状期2个月。食管上段1例,中段8例,下段6例。溃疡型6例,髓质型5例,缩窄型3例,蕈伞型1例。病灶长3.5cm～10cm,平均6.0cm。单纯小细胞癌型13例,混合鳞癌型1例,双重癌1例。15例中手术探查12例,其中切除7例,短路2例,单纯探查术3例。12例均给予辅助化疗,选用CCOM方案。放疗加化疗1例,单纯化疗2例。15例均随访,13例死亡,1例失访,1例尚在治疗中。14例中位生存期7个月。手术切除加化疗组7例中,2例最长生存20个月,中位生存期11个月。手术切除加辅助化疗,略优于其它治疗组。

原发性食管小细胞癌

目的 对原发性食管小细胞癌的临床表现、病理学特征和治疗的有关问题进行分析。 方法 9例食管小细胞癌患者均接受根治性切除、区域淋巴结清扫和胃代食管胸内或颈部吻合术。术后均进行补充化学药物治疗和局部放射治疗。 结果 全组病例手术切除率 10 0 % ,无手术死亡。经随访 ,肿瘤无局部复发 ,但多因肿瘤血循环转移而死亡。 结论 原发性食管小细胞癌是一种临床上较为少见 ,但恶性程度很高的肿瘤 ,早期诊断有利于肿瘤根治性手术 ,而术后采用补充化疗和肿瘤局部放射治疗可提高手术的疗效。

食管小细胞癌临床病理及免疫组织化学研究

目的 研究食管原发小细胞癌的临床病理特征及其组织发生。方法 采用免疫组织化学方法。结果 单纯小细胞癌７ 例，中间细胞型４ 例，混合型３ 例。免疫组织化学上，细胞角蛋白阳性１０ 例，上皮膜抗原阳性１２ 例，ＮＳＥ阳性１３ 例，嗜铬粘蛋白Ａ阳性６ 例，突触素阳性４ 例。随访病例中６ 例在半年内死亡。结论 本研究证明食管小细胞癌是一种高度恶性的肿瘤，组织发生上支持来自全能干细胞。

CD56 CgA Syn在92例原发食管小细胞癌中的表达及临床意义和预后分析

目的:探讨神经内分泌标志物突触素(synaptophysin,Syn)、神经细胞黏附分子56(neuronal cell adhesion molecules 56,CD56)、嗜铬粒蛋白A(chromogranin A,CgA)在92例食管小细胞癌(primary esophageal small cell carcinoma,PESC)中的表达,并分析其表达与患者临床病理特征和预后间关系。方法:采用免疫组织化学法(immunohistochemisty,IHC)检测PESC中CD56、CgA、Syn分子表达;logistic回归分析其与患者临床病理特征关系;Kaplan-Meier法、Cox多因素回归法进行单因素和多因素生存分析;Log-rank法比较各组间生存曲线差异。结果:食管下段癌组织中CgA阳性表达率高于食管中、上段(72.2%vs.41.1%vs.10.0%),且差异具有统计学意义(P=0.001)。CD56、CgA、Syn表达与患者性别(P=0.262,0.998,0.931)、年龄(P=0.250,0.998,0.703)、肿瘤浸润深度(P=0.253,0.997,0.061)、淋巴结有无转移(P=0.767,0.998,0.613)无关;N1、N0的PESC生存期差异无统计学意义(P=0.563);PESC混合鳞癌(HR=2.58;95%CI:1.11~5.98)及CgA阳性表达PESC(HR=1.87;95%CI:1.02~3.43)预后优于单纯PESC及CgA阴性表达患者。结论:CgA表达与PESC肿瘤部位有关;淋巴结有无转移不影响PESC患者预后;组织学类型及CgA表达是PESC患者预后独立影响因素。