宫颈神经内分泌癌化疗反应性及预后影响因素的初步观察

发布时间：2018-05-17 19:54

本文选题：宫颈神经内分泌癌 + 临床病理特征　；参考：《重庆医科大学》2014年硕士论文

【摘要】：目的：总结宫颈神经内分泌癌患者的临床及病理特点，分析其对化疗的反应性和预后影响因素，探讨初始化疗对宫颈神经内分泌癌的治疗价值。方法：回顾性分析了2011年1月至2014年1月在我院就诊的17例宫颈神经内分泌癌患者的临床、病理及随访资料。通过比较15例新辅助化疗后手术的患者治疗前宫颈局部肿瘤大小与术后剖视标本所见情况及病理报告结果，评估宫颈神经内分泌癌患者对初始化疗的反应性。此外，分析患者复发转移和生存情况，探讨不同临床病理因素对患者预后的影响。结果：17例患者的中位年龄为44岁（范围31-69岁）。疾病早期6例，晚期11例。2例患者行全程放化疗，其余15例均在新辅助化疗后行手术，术后补充化疗或放疗。15例手术患者中9例为单纯性神经内分泌癌，而混合型占40.0%（6/15）。所有患者均对至少1种神经内分泌性标志物染色呈阳性改变。深肌层浸润者3例（20.0%）；3例（20.0%）伴淋巴结转移；2例（13.3%）脉管内见癌栓。接受新辅助化疗后，80.0%（12/15）的患者获得临床反应性，而病理学完全和部分反应者分别为20.0%（3/15）和60.0%（9/15），3例疾病稳定，没有患者出现疾病进展。目前有6例患者复发，单因素分析提示年龄、期别、肿瘤同源性、局部肿瘤大小、总化疗周期均与疾病复发和生存状况无明显相关性，而淋巴结转移、深肌层浸润及患者对新辅助化疗的反应性可能会影响其预后。结论：宫颈神经内分泌癌发生率较低，，其恶性程度高，较其他类型的宫颈癌预后差。淋巴结转移情况、肌层浸润深度及患者对新辅助化疗的反应性可能为疾病的预后影响因素。联合化疗、放疗及手术的综合治疗可能会改善患者预后。
[Abstract]:Objective: to summarize the clinical and pathological features of patients with cervical neuroendocrine carcinoma, analyze its reactivity to chemotherapy and prognostic factors, and explore the value of initial chemotherapy in the treatment of cervical neuroendocrine carcinoma. Methods: the clinical, pathological and follow-up data of 17 patients with cervical neuroendocrine carcinoma from January 2011 to January 2014 were retrospectively analyzed. By comparing the size of local cervical tumor before and after neoadjuvant chemotherapy in 15 patients with neoadjuvant chemotherapy and the results of pathological report, the reactivity of cervical neuroendocrine carcinoma to initial chemotherapy was evaluated. In addition, the recurrence, metastasis and survival of the patients were analyzed, and the influence of different clinicopathological factors on the prognosis of the patients was discussed. Results the median age of 17 patients was 44 years (range 31-69 years). The patients were treated with radiotherapy and chemotherapy in the early stage (6 cases), late stage (11 cases), and neoadjuvant chemotherapy (15 cases). Among the 15 cases of postoperative chemotherapy or radiotherapy, 9 cases were simple neuroendocrine carcinoma, while the mixed type accounted for 40.0% of 15 cases. All patients showed positive staining for at least one neuroendocrine marker. Tumor embolus was found in 3 cases with deep muscular infiltration (3 cases with 20. 0) and with lymph node metastasis (2 cases with lymph node metastasis in 2 cases). After neoadjuvant chemotherapy, the patients who received neo-adjuvant chemotherapy received clinical reactivity, but the pathological responses were 20.0 / 15 and 60.09 / 15, respectively. Single factor analysis showed that age, stage, tumor homology, local tumor size and total chemotherapy cycle had no significant correlation with disease recurrence and survival status, but lymph node metastasis. Deep myometrial infiltration and the responsiveness of patients to neoadjuvant chemotherapy may affect their prognosis. Conclusion: the incidence of cervical neuroendocrine carcinoma is lower, its malignant degree is higher, and the prognosis is worse than that of other types of cervical carcinoma. Lymph node metastasis, depth of myometrial invasion and responsiveness to neoadjuvant chemotherapy may be the prognostic factors of the disease. Combined chemotherapy, radiotherapy and surgery may improve prognosis.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.33

【共引文献】