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目的:探讨泌尿系神经内分泌癌(NEC)的临床特点、病理特征和诊断治方法。方法:回顾性分析24例泌尿系NEC患者的临床资料,其中发生于腹膜后1例,肾上腺1例,肾盂2例,输尿管2例,膀胱15例,精囊1例,前列腺2例。男14例,女10例,年龄16～83岁,平均59岁。结果:经病理检查证实为NEC,免疫组织化学表达嗜铬粒蛋白(CgA)17例,神经特异性烯醇化酶(NSE)19例,腺癌突触素(Syn)6例。采用综合疗法,目前生存12例,最长9年6个月;死亡12例,均在术后1年内死亡。结论:泌尿系NEC临床罕见,确诊需行免疫组织化学或电镜检查;治疗以手术切除联合放化疗为宜,但预后较差。
Objective: To investigate the clinical features, pathological features and diagnosis and treatment of urinary neuroendocrine carcinoma (NEC). Methods: The clinical data of 24 patients with urinary NEC were retrospectively analyzed. Among them, 1 occurred in retroperitoneum, 1 in adrenal gland, 2 in renal pelvis, 2 in ureter, 15 in bladder, 1 in seminal vesicle and 2 in prostate. 14 males and 10 females, aged 16 to 83 years, mean 59 years. Results: Seventeen cases of chromogranin protein (CgA), 19 cases of NSE and 6 cases of adenocarcinoma were diagnosed as NEC by immunohistochemistry. The use of integrated therapy, the current survival of 12 cases, up to 9 years and 6 months; 12 died, were within 1 year after the death. CONCLUSION: Urinary NEC is rare in clinical practice. Immunohistochemical or electron microscopic examination is necessary for diagnosis. Surgical resection combined with chemoradiotherapy is appropriate, but the prognosis is poor.