原发性宫颈小细胞癌临床病理分析

摘要

[Objective] To study the clinicopathological characterises of small cell carcinoma of the cervix (SCCC) and the factors for prognosis. [Method] We collected all the cases of cervical carcinoma during 1996 and 2008. Among these, there were 25 cases of SCCC, and 24 cases were confirmed as SCCC with complete data. Patients' age, presenting symptoms, disease stage, tumour size, treatment and follow-up were reported. Histological features were observed and immunohistochemical detection of cytokeratin (CK), epithelial membrane antigen (EMA), neuron specific enolase (NSE), synaptophysin (Syn), chromogranin A (CgA), neuronal cell adhesion molecules (CD56), thyroid transcriptional factor-1 (TTF-1) and S100 protein (S100) was performed. [Result] The median age of patients in this study was 44.8 years old. The median patient survival time was 19.2 months after diagnosis. Histologically, there were 18 homogenous SCCC samples and 6 samples comprised of SCCC and other histological categories. The percentages of SCCC with positive immunoreactivity were, NSE 100.0%, Syn 95.8%, CD56 66.7% , CgA 79.2%, TTF-1 37.5%, EMA 83.3%, CK 66.7%, and S100 8.3%. [Conclusion] SCCC was a kind of malignant tumour on cervical epithelium. It was rare, aggressive and with poor prognosis. The main treatment was operation, assisted with other methods. Pathological study showed high proportion of positive labelling of NSE, Syn, CD56 and CgA. Combinate detection of these four markers would be valuable for diagnosis.%[目的]探讨宫颈小细胞癌(SCCC)的临床病理特征及预后因素。[方法]收集中山大学肿瘤防治中心1996年至2008年宫颈癌病例4 075例，25例为宫颈小细胞癌，其中临床病理资料完整者24例。回顾性分析总结患者年龄、症状、疾病FIGO分期、肿瘤大小、治疗方案及预后。应用免疫组化技术检测宫颈小细胞中CK、EMA、NSE、Syn、CgA、CD56、TTF-1和S100的表达，并分析其特征。[结果]24例病例的中位年龄为44.8岁。中位生存时间为初次确诊后19.2月。病理资料显示18例为单纯宫颈小细胞癌,6例为宫颈小细胞癌合并其他类型宫颈恶性肿瘤。此24例SCCC免疫组化显示：NSE 100.0％，Syn95.8％,CD56 66.7％,CgA 79.2％，TrF-1 37.5％，EMA 83.3％，CK 66.7％及S100 8.3％。[结论]SCCC为宫颈上皮恶性肿瘤罕见的一种类型,发病率低，恶性程度高，预后差。治疗以手术为主，辅以其他方法治疗。免疫组织化学研究显示：NSE、Syn、CD56及CgA的联合检测有提高病理诊断意义。