18例宫颈小细胞癌临床病理分析.docVIP

18例宫颈小细胞癌临床病理分析 　　摘要：目的 分析宫颈小细胞癌的临床及病理特征。方法 回顾性分析我院收治的18例宫颈小细胞癌的临床资料及病理资料。结果 18例患者平均年龄45. 2±11.4 岁，8例年龄≤40 岁，5 年生存率为11. 50%；10例 40 岁，5 年生存率为15.71% （ P 0. 05） 。5例浸润 1 /2 肌层，5 年生存率为32.54%；13 例浸润≥1 /2 肌层， 5 年生存率为10. 51%（ P 0. 05） ；淋巴结转移15例，5 年生存率11. 07%；无淋巴结转移3例，5 年生存率28. 95% （ P 0. 05） 。Ⅰ ～ⅡA 期15 例，ⅡB ～Ⅳ期3 例，5 年生存率分别为21. 10%，8. 40%。光镜下肿瘤细胞大小形态一致，均呈圆形或卵圆形，胞浆少，核大、深染，核分裂相多见。癌细胞呈弥漫或密集片状排列，大面积浸润间质，有不规则的坏死或出血。免疫表型：CKpan、Syn、p16阳性，CgA 、CD45、 p63阴性。3例（16.7%）HPV16 /18检查结果为阳性。电镜检查：细胞间可见桥颗粒，胞质内有大小不等，直径月200nm的神经内分泌颗粒。结论 宫颈小细胞癌为神经内分泌肿瘤，预后差。肿瘤细胞形态特殊，免疫组化检查有利于疾病的诊断。 　　关键词：宫颈小细胞癌 临床特征 病理特征 预后 　　Abstract：Objective To investigate the clinicopathological of the small cell carcinoma of the cervix （ SCCC）. Methods Review of the clinical data and pathological data of 18 cases of small cell carcinoma of the cervix were treated in our hospital.Results The average age of the 18 cases was 45.2±11.4 years. In 8 patients， aged less than 40 years， 5 years survival rate was 11.50%； 10 patients 40 years， 5 years survival rate was 15.71% （P 0.05）. 5 cases of muscular layer infiltration was less than 1 /2， the 5 year survival rate was 32.54%； 13 cases of muscular layer infiltration is greater than or equal to 1 /2， the 5 year survival rate was 10.51% （P 0.05）； Lymph node metastasis in 15 cases， 5 years survival rate was 11.07%； 3 cases without lymph node metastasis， 5 year survival rate was 28.95% （P 0.05）. I ～ II stage A 15 cases， B in 3 cases of II ～ IV， 5 year survival rates were 21.10%， 8.40%. Tumor cells at the same size and morphology by light microscopy， were round or oval， less cytoplasm， nucleus was big and deep staining， nuclear division phase. Cancer cells showed diffuse or densely arranged in the shape of a large area of infiltration， interstitial， irregular necrosis or hemorrhage. Immunohistochemically， CKpan， Syn， CgA， CD45， p16 positive， p63 negative. In 3 cases （16.7%） were positive for HPV16 and /18 examination results. Electron microscope： cells can be seen between the par