论文部分内容阅读
目的 研究子宫颈小细胞癌 (SCCC)的临床病理特征、预后的影响因素、化疗疗效及其对生存期的影响。方法 分析 12例SCCC患者的临床病理资料。全部标本均行上皮性细胞免疫标记物和与神经内分泌细胞相关的免疫标记物的检测 ,呈阳性反应。临床分期Ⅰb1期 2例 ,Ⅰb2 期 4例 ,Ⅱa期 3例 ,Ⅱb期 1例 ,Ⅲb期 1例 ,Ⅳb期 1例。 9例早期SCCC患者中 ,5例患者术前接受新辅助化疗 ,3例接受术后辅助化疗 ;3例晚期患者接受同步放化疗。结果 早期SCCC患者术后病理证实盆腔淋巴结阳性者占 4 4 .4 % ,淋巴结阳性与阴性的平均无瘤生存期为 16 .1∶2 5 .7个月 ,总生存期为 19∶32个月。 5例接受新辅助化疗者手术成功率为 10 0 % ,其中 1例完全缓解 ,3例肿瘤缩小 >5 0 % ,总有效率为 80 % ,术后病理提示化疗反应者 6 0 % ,平均无瘤生存期为 2 3.4个月 ,总生存期为 2 5 .5个月 ,2年生存率为 80 %。 3例术后辅助化疗者平均无瘤生存期为 17.3个月 ,总生存期为 2 8个月 ,2年生存率为 6 6 .2 %。 3例中晚期患者平均无瘤生存期为 18个月 ,总生存期为 2 7.2个月 ,2年生存率为 6 6 .2 %。结论 同时检测与神经内分泌细胞相关的几种免疫标记 ,可以提高诊断SCCC的准确率。早期SCCC患者死亡率高与淋巴道转移和高危因素的发生率高有关。
Objective To study the clinicopathologic features of small cell carcinoma of the cervix (SCCC), the prognostic factors, the curative effect of chemotherapy and its influence on the survival time. Methods Clinical and pathological data of 12 patients with SCCC were analyzed. All samples were detected by epithelial cell immunological markers and neuroendocrine-related immune markers, a positive reaction. The clinical stage Ⅰ b1 in 2 cases, Ⅰ b2 in 4 cases, Ⅱ a in 3 cases, Ⅱ b in 1 case, Ⅲ b in 1 case, Ⅳ b in 1 case. Of 9 early SCCC patients, 5 received neoadjuvant chemotherapy before surgery, 3 received postoperative adjuvant chemotherapy, and 3 received advanced chemoradiation simultaneously. Results Early postoperative pathological diagnosis of pelvic lymph node-positive patients accounted for 44.4%, lymph node positive and negative mean tumor-free survival of 16.1: 2.57 months, the overall survival was 19:32 months . The success rate of 5 cases receiving neoadjuvant chemotherapy was 100%, of which 1 was completely relieved, 3 cases of tumor shrinkage> 50%, the total effective rate was 80%, postoperative pathology prompted chemotherapy response of 60%, the average no Tumor survival was 23.4 months, with a total survival of 25.5 months and a 2-year survival of 80%. The 3 patients with postoperative adjuvant chemotherapy had an average disease-free survival of 17.3 months, a total survival of 28 months and a 2-year survival of 62.2%. Three patients with advanced disease-free survival of 18 months, the overall survival was 7.22 months, 2-year survival rate of 6 6 .2%. Conclusion Simultaneous detection of several immune markers associated with neuroendocrine cells can improve the accuracy of diagnosis of SCCC. High mortality in early SCCC patients is associated with a high incidence of lymphatic metastasis and high-risk factors.