目的妇科原发性小细胞癌病例罕见,预后差。结合北京大学第三医院病例探讨妇科原发性小细胞癌的发病特点以及诊断治疗方案。方法回顾性分析2006-01-01-2015-08-31北京大学第三医院收治的经病理确诊的8例妇科原发性小细胞癌患者的临床特征、治疗方案以及预后。结果患者年龄16~71岁,中位年龄43岁。常见症状包括阴道异常出血、腹痛、腹部包块等。诊断主要依靠手术病理确诊,其中宫颈小细胞癌ⅠB 1期2例,ⅠB 2期2例,ⅢB期1例;卵巢小细胞癌ⅢC期1例;子宫内膜小细胞癌Ⅳ期2例。治疗方案包括手术、化疗和放疗。手术方式参照相应部位肿瘤的治疗原则,有5例行广泛子宫切除术,2例行肿瘤细胞减灭术,1例因高龄伴高血压未行手术。7例手术患者中有3例接受术前化疗,7例术后均辅助化疗,有5例辅助术后放疗。随访至2015-12-20,无患者失访。有3例生存,分别随访22、22和56个月;5例死亡,生存期分别为2、8、10、22和31个月。患者疾病无进展生存时间(progression-free survival,PFS)为0.3~56个月,中位PFS为15个月,总生存时间(overall survival,OS)为2~56个月,中位OS为22个月。结论妇科小细胞癌术前影像学检查常有淋巴结转移,其确诊依靠组织病理学检查。该肿瘤预后差,手术是早期病变的主要治疗手段,晚期病例宜采用手术、化疗和放疗相结合的综合治疗。 The purpose of gynecologic primary small cell carcinoma of the rare cases, the prognosis is poor. Combined Peking University Third Hospital cases of gynecologic primary small cell carcinoma of the onset characteristics and diagnosis and treatment programs. Methods Retrospective analysis of the clinical features, treatment and prognosis of 8 patients with gynecologic primary small cell carcinoma confirmed by pathology admitted to Peking University Third Hospital from January 2006 to January 2015. Results The patients were 16 to 71 years old with a median age of 43 years. Common symptoms include abnormal vaginal bleeding, abdominal pain, abdominal mass and so on. Diagnosis mainly depends on the surgical pathology, including 2 cases of cervical small cell carcinoma Ⅰ B 1, 2 cases of Ⅰ B 2, 1 case of stage Ⅲ B, 1 case of ovarian small cell carcinoma Ⅲ C and 2 cases of endometrial small cell carcinoma Ⅳ. Treatment options include surgery, chemotherapy and radiation. Refer to the corresponding part of the surgical approach to the treatment of tumor, there are 5 cases of extensive hysterectomy, 2 cases of cytoreductive surgery, 1 case of advanced surgery with hypertension. Three of the seven surgical patients underwent preoperative chemotherapy, seven received postoperative adjuvant chemotherapy and five assisted postoperative radiotherapy. Follow-up to 2015-12-20, no patient lost. Three patients survived and were followed up for 22, 22 and 56 months respectively. Five patients died, with survival rates of 2, 8, 10, 22 and 31 months respectively. The patients had progression-free survival (PFS) of 0.3 to 56 months, median PFS of 15 months, overall survival (OS) of 2 to 56 months and median OS of 22 Months. Conclusion Preoperative imaging of gynecologic small cell carcinoma often lymph node metastasis, the diagnosis depends on histopathological examination. The poor prognosis of the tumor, surgery is the main treatment of early lesions, advanced cases should use surgery, chemotherapy and radiotherapy combination of comprehensive treatment.