原发卵巢小细胞癌临床病理特点及预后分析（附4例报告及文献复习）

摘要

目的：探讨原发性卵巢小细胞癌（Small Cell Carcinoma of the Ovary，SCCO）临床病理特点、诊断、治疗及预后。方法：对中国医学科学院肿瘤医院2005年1月至2012年12月收治的4例SCCO病例资料进行回顾性分析。结果：4例SCCO患者平均发病年龄43.75（17～57）岁；绝经后2例，<30岁l例。Ⅰ期1例，Ⅲ～Ⅳ期3例。除1例无法分型外，余3例均为肺型。4例患者中1例行保留生育功能手术，3例行减瘤术；4例患者术后均给予铂类为基础的多药联合化疗，3例行TC方案化疗，无术后放疗者。本组治疗后随诊7～30个月，2例于初次诊断后的9、12个月死于本病，2例治疗后分别生存7、30个月，无复发迹象。结论：SCCO较罕见，预后差，免疫组织化学检测可用于鉴别诊断。治疗上以减瘤术及术后铂类为基础化疗为主要手段，最优化疗方案仍需进一步研究。%Objective:This study analyzes the clinicopathological characteristics, pathological diagnosis, treatment, and prognosis of ovarian small cell carcinoma (SCCO). Methods:The medical records of SCCO patients in the Cancer Hospital of Peking Union Medical College between 2005 and 2012 were reviewed. Results:The mean age of patients was 43. 75 years old (ranging from 17 to 57), two cases were postmenopausal, and one case was less than 30 years old. Twenty-one patients had FIGO stageⅠ, whereas three cases had stageⅢto Ⅳ. Three cases were classified as pulmonary type. Forty-three patients received cytoreductive surgery, and one underwent fertili ty-conserving surgery. All patients were postoperatively treated with platinum-based chemotherapy, whereas three cases received Paclitaxel plus Carboplatin. No patient received adjuvant radiotherapy. One patient died nine months after the initial diagnosis, and one died 12 months after the initial diagnosis. The other two cases remain alive with no evidence of recurrence after follow up at 7 and 30 months after diagnosis. Conclusion:SCCO is a rare ovarian tumor with high malignancy potential and thus has poor prognosis. The clinical manifestations of SCCO resemble those of epithelial ovarian cancer. Immunohistochemistry can be used for differential diagnosis. The standard SCCO treatments are cytoreductive surgery and adjuvant platinum-based chemotherapy. The optimal chemotherapy regimen requires further research.