101例宫颈小细胞神经内分泌癌患者的临床治疗及预后分析

乔志强; 李明梅; 李隆玉

doi:10.3971/j.issn.1000-8578.2019.19.0123

101例宫颈小细胞神经内分泌癌患者的临床治疗及预后分析

Clinical Treatment and Prognosis of 101 Patients with Small Cell Neuroendocrine Carcinoma of Cervix

摘要

摘要:
目的探讨宫颈小细胞神经内分泌癌（SCNEC）患者的临床治疗及预后影响相关因素。
方法选取江西省妇幼保健院101例SCNEC患者ⅠB1期-ⅡA期手术治疗组72例，ⅡB-Ⅳ期根治性放化疗组29例，对患者的年龄、临床分期、肿瘤大小、治疗及生存率等进行回顾性分析。
结果 72例手术患者中，51例生存，生存时间1~139月，五年生存率60.6%。29例根治性放化疗患者中，随访5年以上20例，五年生存率15%。不同分期患者生存率差异有统计学意义（P=0.0025）；淋巴结阴性与阳性患者生存率差异有统计学意义（P=0.0004）。混合型与单纯型患者生存率差异无统计学意义（P=0.0546）。
结论宫颈SCNEC患者临床分期、淋巴结转移情况与预后密切相关，是否混合其他病理类型对生存率无影响。早期手术治疗患者预后明显优于中晚期根治性放化疗患者。

Abstract:
Objective To investigate the clinical treatment and prognostic factors of cervical small cell neuroendocrine carcinoma (SCNEC).
Methods We selected 101 SCNEC patients in Jiangxi Maternal and Child Health Hospital and analyzed retrospectively age, clinical stage, tumor size, treatment and survival rate. All patients were divided into surgery group (stage ⅠB1-ⅡA, surgery+chemoradiotherapy, n=72) and concurrent chemoradiotherapy(CCRT) group (stage ⅡB-Ⅳ, concurrent radiotherapy and chemotherapy, n=29).
Results In surgery group, 51 patients survived for 1-139 months. The 5-year survival rate was 60.6%. In CCRT group, 20 patients were followed up for more than five years, with a 5-year survival rate of 15%. The survival rates of patients with different stages were significantly different (P=0.0025); those of patients with negative and positive lymph node were significantly different (P=0.0004); those of patients with pure and mixed type were not significantly different (P=0.0546).
Conclusion The prognosis of patients with cervical SCNEC are closely related to the clinical stage and lymph node metastasis. The prognosis of early stage patients treated with surgery is significantly better than that of advanced stage patients treated with radical chemoradiotherapy.

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