摘要
目的 妇科原发性小细胞癌病例罕见,预后差。结合北京大学第三医院病例探讨妇科原发性小细胞癌的发病特点以及诊断治疗方案。方法 回顾性分析2006-01-01-2015-08-31北京大学第三医院收治的经病理确诊的8例妇科原发性小细胞癌患者的临床特征、治疗方案以及预后。结果 患者年龄16～71岁,中位年龄43岁。常见症状包括阴道异常出血、腹痛、腹部包块等。诊断主要依靠手术病理确诊,其中宫颈小细胞癌ⅠB 1期2例,ⅠB 2期2例,ⅢB期1例;卵巢小细胞癌ⅢC期1例;子宫内膜小细胞癌Ⅳ期2例。治疗方案包括手术、化疗和放疗。手术方式参照相应部位肿瘤的治疗原则,有5例行广泛子宫切除术,2例行肿瘤细胞减灭术,1例因高龄伴高血压未行手术。7例手术患者中有3例接受术前化疗,7例术后均辅助化疗,有5例辅助术后放疗。随访至2015-12-20,无患者失访。有3例生存,分别随访22、22和56个月;5例死亡,生存期分别为2、8、10、22和31个月。患者疾病无进展生存时间（progression-free survival,PFS）为0.3～56个月,中位PFS为15个月,总生存时间（overall survival,OS）为2～56个月,中位OS为22个月。结论妇科小细胞癌术前影像学检查常有淋巴结转移,其确诊依靠组织病理学检查。该肿瘤预后差,手术是早期病变的主要治疗手段,晚期病例宜采用手术、化疗和放疗相结合的综合治疗。
OBJECTIVE Gynecological primary small cell carcinoma is quite rare and has poor prognosis. The objective of this study was to explore the clinical characteristics, diagnosis and therapy for primary small cell carcinomas of the gynecologic tract. METHODS In Peking University Third Hospital, eight patients diagnosed with primary small cell carcinomas of gynecologic tract between Januray 1, 2006 and August 31, 2015 were enrolled. Clinical features, therapies and prognosis were retrospectively evaluated in these patients. RESULTS The onset ages of these patients were between sixteen and seventy-one years old, and the median onset age was fortythree years old. Typical symptoms included abnormal vaginal bleeding, bellyache, or abdominal mass. Diagnosis was confirmed by pathological analysis after surgery. Among 5 cases of small cell carcinoma of the cervix, two were at stage I B 1, two were at stage I B 2, and the other was at stage ⅢB. one case of ovarian small cell carcinoma was at stage Ⅲ C, and 2 cases of endometrial small cell carcinoma were at stage Ⅳ. Therapeutic management included surgery, radiotherapy and chemotherapy. Among eight patients, five received radical hysterectomy, two received tumor debulking surgery, and one received non-surgical treatment for her old age and poor blood pressure control. Out of seven patients who received surgery, three patients received preoperative chemotherapy, all received postoperative chemotherapy, and five were given radiotherapy. Up to December 2015, there was no loss of follow-up cases. Three cases survived after 22,22 and 56 months＇ follow-up, respectively. Five cases died, and the survival time were respectively 2 months, 8 months, 10 months, 22 months, and 31 months. Progression free survival （PFS） was between 0.3 and 56 months, and median PFS was 15 months. Total survival time （OS） was 2-56 months, and median OS was 22 months. CONCLUSIONS For patients with primary small cell carcinomas of gynecologic tract, lymphatic metastasis is often found in preop
出处
《中华肿瘤防治杂志》
CAS
北大核心
2016年第3期194-197,202,共5页
Chinese Journal of Cancer Prevention and Treatment
关键词
妇科肿瘤
小细胞癌
联合治疗
预后
gynecologic neoplasms
small cell carcinomas
combination therapy
prognosis
