Department of Radiation Oncology, Cancer Therapy and Research Center, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
Am J Clin Oncol. 2013 Jun;36(3):299-309. doi: 10.1097/COC.0b013e318210f83c.
Merkel cell carcinoma (MCC) is a rare, clinically aggressive cutaneous neuroendocrine neoplasm with a high mortality rate. Though the etiology is not precisely known, Merkel cell polyomavirus DNA has been found recently in a large percentage of MCC tumors. Other suggested risk factors include sun exposure, immunosuppression, and a history of prior malignancy. Work up of patients with MCC most notably includes nodal staging via clinical examination or sentinel lymph node biopsy. The prognosis for most patients with MCC is poor, and the rarity of MCC precludes the prospective, randomized clinical trials necessary to elucidate optimum treatment protocols. Most published data support the use of a multimodality approach centered around surgical excision with negative margins, sentinel lymph node biopsy to establish the presence or absence of nodal metastases, adjuvant radiothearpy to decrease the risk of recurrence, and systemic chemotherapy in the case of widespread disease.
默克尔细胞癌(Merkel cell carcinoma,MCC)是一种罕见的、临床侵袭性皮肤神经内分泌肿瘤,死亡率较高。尽管其病因尚不清楚,但最近在很大比例的 MCC 肿瘤中发现了默克尔细胞多瘤病毒 DNA。其他被认为的危险因素包括阳光暴露、免疫抑制和既往恶性肿瘤病史。MCC 患者的检查主要包括通过临床检查或前哨淋巴结活检进行淋巴结分期。大多数 MCC 患者的预后较差,而且 MCC 的罕见性排除了阐明最佳治疗方案所需的前瞻性、随机临床试验。大多数已发表的数据支持以手术切除为中心的多模式方法,手术切除需要切缘阴性,前哨淋巴结活检以确定是否存在淋巴结转移,辅助放疗以降低复发风险,以及在广泛疾病的情况下进行全身化疗。