Grignon D J, Ro J Y, Ayala A G, Shum D T, Ordóñez N G, Logothetis C J, Johnson D E, Mackay B
Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston 77030.
Cancer. 1992 Jan 15;69(2):527-36. doi: 10.1002/1097-0142(19920115)69:2<527::aid-cncr2820690241>3.0.co;2-7.
Small cell carcinoma of the urinary bladder is an uncommon tumor. The authors report the clinicopathologic findings in a series of 22 cases. Fifteen men and 7 women were studied; their ages ranged from 51 to 87 years (mean, 62.4 years). The most frequent presentation was hematuria (94.4%). At diagnosis, three patients had Stage B disease, six had Stage C, and ten had Stage D (unknown stage in three). Histologically, 6 were oat cell type tumors, 11 were of intermediate cell type, and 5 were of combined cell type. Immunohistochemical studies demonstrated positivity for neuron-specific enolase in ten of ten cases, cytokeratin in seven of ten cases, chromogranin in eight of nine cases, serotonin in seven of nine cases, and S-100 protein in four of ten cases. Neuroendocrine differentiation was seen in five of seven cases examined by electron microscopy. Treatment and follow-up data were available for 19 patients: 10 (52.6%) were dead of disease, 5 (26.3%) were alive and well, 3 (15.8%) were alive with disease, and 1 (5.3%) died of an unrelated cause. The 2-year survival rate was 50% for patients with Stage B, 25% for patients with Stage C, and 33% for patients with Stage D disease. Although overall survival was poor, some cases responded well to therapy. Based on the authors' experience, radical cystectomy with adjuvant chemotherapy appears to be the treatment of choice.
膀胱小细胞癌是一种罕见的肿瘤。作者报告了一系列22例病例的临床病理结果。研究对象包括15名男性和7名女性；年龄范围为51至87岁（平均62.4岁）。最常见的表现是血尿（94.4%）。诊断时，3例患者为B期疾病，6例为C期，10例为D期（3例分期不明）。组织学上，6例为燕麦细胞型肿瘤，11例为中间细胞型，5例为混合型。免疫组织化学研究显示，10例中有10例神经元特异性烯醇化酶呈阳性，10例中有7例细胞角蛋白呈阳性，9例中有8例嗜铬粒蛋白呈阳性，9例中有7例血清素呈阳性，10例中有4例S-100蛋白呈阳性。7例经电子显微镜检查的病例中有5例可见神经内分泌分化。有19例患者的治疗和随访数据：10例（52.6%）死于疾病，5例（26.3%）存活且情况良好，3例（15.8%）带瘤存活，1例（5.3%）死于无关原因。B期患者的2年生存率为50%，C期患者为25%，D期疾病患者为33%。尽管总体生存率较低，但一些病例对治疗反应良好。根据作者的经验，根治性膀胱切除术联合辅助化疗似乎是首选的治疗方法。
