Niu Yan-yan, Chen Xing-ming, Gao Zhi-qiang
Department of Otolaryngology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2011 May 31;91(20):1405-7.
To summarize the clinical features of laryngeal neuroendocrine carcinoma (LNEC).
The clinical data of all LNEC patients hospitalized during the period of June 1988 - December 2010 were analyzed retrospectively.
Among all LNEC 12 patients as confirmed by pathological examination, there were typical carcinoid (n = 1), atypical carcinoid (n = 4) (2 with cervical metastasis, 1 with paraneoplastic syndrome), small cell neuroendocrine carcinoma (n = 7) (1 with adenocarcinoma). All patients with typical and atypical carcinoid underwent surgery. And postoperative radiotherapy was offered for those diagnosed with advanced stage or cervical metastasis. They were followed up for 1 - 12 years without local recurrence. All patients with laryngeal small cell neuroendocrine carcinoma received chemotherapy and radiotherapy. And the follow-up period was 0.5 - 6 years. One died of pulmonary metastasis within half a year while another died of liver metastasis within 3 years.
It is important to classify the LNEC patients correctly since their clinical course, treatment and prognosis varies greatly with the diagnosis. For typical and atypical carcinoid of larynx, partial or total laryngectomy and neck dissection may be performed depending on the site and extent of primary tumor. However, for laryngeal small cell neuroendocrine carcinoma, the mainstay of treatment is made up of chemotherapy and radiotherapy. And the prognosis of this type remains very poor.
总结喉神经内分泌癌(LNEC)的临床特征。
回顾性分析1988年6月至2010年12月期间住院的所有LNEC患者的临床资料。
经病理检查确诊的12例LNEC患者中,有典型类癌(n = 1)、非典型类癌(n = 4)(2例有颈部转移,1例有副肿瘤综合征)、小细胞神经内分泌癌(n = 7)(1例合并腺癌)。所有典型和非典型类癌患者均接受了手术治疗。对于诊断为晚期或有颈部转移的患者,术后给予放疗。随访1 - 12年,无局部复发。所有喉小细胞神经内分泌癌患者均接受了化疗和放疗。随访时间为0.5 - 6年。1例在半年内死于肺转移,另1例在3年内死于肝转移。
正确分类LNEC患者很重要,因为其临床病程、治疗和预后因诊断不同而有很大差异。对于喉典型和非典型类癌,可根据原发肿瘤的部位和范围行部分或全喉切除术及颈部淋巴结清扫术。然而,对于喉小细胞神经内分泌癌,治疗的主要方法是化疗和放疗。且该类型的预后仍然很差。