宫颈大细胞神经内分泌癌的诊治进展.pdf

• 40 • 国际妇产科学杂志 2017 年 2 月第 44 卷第 1 期 J Int Obstet Gynecol, February 2017 Vol.44,No. ， 1 • 综述• 宫颈大细胞神经内分泌癌的诊治进展 李 俊 敏 ，席 勇 ，高 景 春 。 【摘 要 】 宫颈大细胞神经内分泌癌（large cell neuroendocrine carcinoma LCNEC)， 是一种罕见类型的宫颈恶性肿 瘤，因其复发率高，易发生早期转移，具有高度侵袭性，故即使在早期经系统治疗，其预后也极差。宫颈 LCNEC 临床表 现与其他类型宫颈癌无异，目前术前及术后标本的组织病理学及免疫组织化学检查是其主要的诊断方法。一部分宫颈 LCNEC患者存在高危型人乳头瘤病毒(HPV)感染，但该病发生与高危型HPV 感染无关。由于其独特的生物学特性，所 宫颈LCNEC 的预后较差，随访较其他类型宫颈癌更加频繁。宫颈LCNEC 的治疗方案主要是通过回顾总结得到，目前 尚无统一治疗方法。因其与宫颈小细胞神经内分癌有相似的生物学特征，所以其治疗方案主要参考宫颈小细胞神经内 分泌癌，主要采用联合治疗方法，手术联合放化疗有助于提高患者的远期生存率，因此有关宫颈LCNEC 的诊治研究更 为迫切。 【关键词】 宫颈肿瘤;癌，神经内分泌;诊断;治疗;预后 Progress of Diagnosis and Treatment of Large Ce Neuroendocrine Carcinoma of the Uterine Cervix LI Jun -min, XI Yong, GAO Jing-chun. Department of Gynecology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China Corresponding author: GAO Jing-chun, E-mail: jingchun_gao@ Abstract【 】 Large cell neuroendocrine carcinoma (LCNEC) of the uterine cervix is a rare but highly aggressive malignancy that tends to spread and recur early even in its early stage. The prognosis is very poor despite multimodal treatments. The clinical symptoms of LCNEC of the uterine cervix are similar to others kinds of cervical cancer. And the accurate diagnosis requires tissue pathology and immunohistochemistry for nueroendocrine markers. Neuroendocrine carcinomas sometimes are infected with high-risk human papillomavirus (HPV), but they are the subtype of cervical cancer that does not appear to be associated with HPV exposure. Because of the aggressive nature of LCNEC of the uterine cervix, the expert examine the patients more frequently in the postreatment period. The overwhelming majority of available dat