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目的探讨宫颈小细胞癌的临床病理特征、诊断、治疗与预后的影响因素。方法收集26例宫颈小细胞癌的资料,回顾性分析其临床病理学特点、诊断要点及预后。结果 26例患者中位发病年龄36.5岁,均确诊为小细胞癌,免疫组化染色阳性抗体主要为Syn(23/23)、Cg A(14/22)、CD56(16/18)。所有患者均行化疗,其中22例行根治性子宫切除术+术后放化疗。患者3年总体生存率和无病生存率分别为64.3%和60%。FIGOⅠb-Ⅱa期与Ⅱb-Ⅳ期患者3年总体生存率分别为81.8%和25%,差异显著(P<0.05);肿瘤直径≤4 cm者比肿瘤大者3年生存率更高(P<0.05);Cg A阳性者比阴性者更易发生复发或转移(P<0.05)。结论宫颈小细胞癌确诊依靠组织形态学特点和免疫组化结果;目前多采用手术、化疗和放疗综合治疗;FIGO分期、肿瘤大小及Cg A染色情况与预后相关。
Objective To investigate the clinicopathological characteristics, diagnosis, treatment and prognosis of cervical SCLC. Methods The data of 26 cases of small cell carcinoma of the cervix were collected. The clinicopathological features, diagnosis points and prognosis were retrospectively analyzed. Results The median age of onset was 36.5 years (26.5%). Small cell carcinoma was diagnosed in all 26 cases. The positive immunohistochemical antibodies were Syn (23/23), Cg A (14/22) and CD56 (16/18). All patients underwent chemotherapy, of which 22 cases of radical hysterectomy + postoperative radiotherapy and chemotherapy. Three-year overall survival and disease-free survival were 64.3% and 60%, respectively. The 3-year overall survival rates of patients with FIGOⅠb-Ⅱa and Ⅱb-Ⅳ were 81.8% and 25%, respectively, with significant difference (P <0.05). The 3-year survival rate of patients with tumor diameter less than 4 cm was higher than that of the patients with large tumor (P < 0.05). Cg A positive patients were more likely to relapse or metastasize than negative ones (P <0.05). Conclusions The diagnosis of small cell carcinoma of the cervix depends on histomorphological characteristics and immunohistochemical results. At present, it is mostly combined with surgery, chemotherapy and radiotherapy. FIGO stage, tumor size and Cg A staining are correlated with prognosis.