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目的探讨宫颈小细胞癌(small cell carcinoma of cervix,SCCC)的临床病理特点,分析治疗效果及预后。方法回顾性分析2009年1月至2015年3月武汉大学人民医院收治的原发性SCCC患者的临床及病理资料,分析治疗方法的选择及预后。结果 13例SCCC占我院同期收治的所有宫颈癌的0.6%。根据国际妇产科联合会2014标准进行分期:ⅠB1期2例,ⅠB2期5例,ⅡA1期2例,ⅡA2期3例,ⅣA期1例。将13例患者根据临床分期的不同分别行新辅助化疗、根治术、术后化疗、同步放化疗等综合治疗。截止2015年3月,平均随访时间为38.6个月,患者中4例死亡,9例无瘤生存。结论 SCCC发病罕见,主要以病理学诊断为主,结合免疫组化染色提高准确率。临床分期Ⅰ期者预后较好,Ⅱ期及以上者进展迅速,恶性程度高,容易发生远处转移。故应对患者进行早期诊断及选择个性化的治疗方式,改善预后提高生存率。
Objective To investigate the clinicopathological features of small cell carcinoma of cervix (SCCC) and to analyze the therapeutic effect and prognosis. Methods The clinical and pathological data of patients with primary SCCC admitted from People ’s Hospital of Wuhan University from January 2009 to March 2015 were retrospectively analyzed. The selection and prognosis of treatment were analyzed. Results 13 cases of SCCC accounted for 0.6% of all cervical cancer admitted to our hospital over the same period. According to the International Federation of Obstetrics and Gynecology 2014 standard staging: Ⅰ B1 2 cases, Ⅰ B2 5 cases, Ⅱ A1 2 cases, Ⅱ A2 2 cases, Ⅳ A case. Thirteen patients underwent neoadjuvant chemotherapy, radical mastectomy, postoperative chemotherapy, concurrent chemoradiotherapy and other comprehensive treatment according to clinical staging. As of March 2015, the average follow-up period was 38.6 months, with 4 deaths and 9 disease-free survival. Conclusions The incidence of SCCC is rare, mainly based on pathological diagnosis, combined with immunohistochemical staining to improve the accuracy. Stage Ⅰ clinical stage prognosis is good, stage Ⅱ and above rapid progress, high degree of malignancy, prone to distant metastasis. Therefore, patients should be diagnosed early and choose a personalized treatment, improve prognosis and improve survival.