默克尔细胞癌：你了解相关指南吗？
Merkel cell carcinoma: Do you know your guidelines?
作者信息
Miles Brett A, Goldenberg David
机构信息
Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine, New York, New York.
Department of Surgery, Division of Otolaryngology - Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania.
出版信息
Head Neck. 2016 May;38(5):647-52. doi: 10.1002/hed.24359. Epub 2015 Dec 30.
BACKGROUND
Merkel cell carcinoma (MCC) is a cutaneous neuroendocrine malignancy that exhibits clinically aggressive features and is associated with a poor prognosis. The incidence of MCC seems to be increasing for reasons unknown, and is estimated to be 0.32/100,000 in the United States.
METHODS
This article will review the current literature and National Comprehensive Cancer Network practice guidelines in the treatment of MCC.
RESULTS
Resection of MCC with negative margins remains the mainstay of therapy. Positive nodal disease should be treated with neck dissection and adjuvant radiotherapy. High-risk patients should undergo adjuvant radiotherapy, which improves oncologic outcomes. The role of chemotherapy is less clear and is currently reserved for advanced-stage MCC and palliative therapy.
CONCLUSION
The pathogenesis of MCC has recently been impacted with the discovery of the Merkel cell polyomavirus (MCPyV). Research to establish targeted and immunologic therapeutic options are ongoing.
背景
默克尔细胞癌（MCC）是一种皮肤神经内分泌恶性肿瘤，具有临床侵袭性特征，预后较差。MCC的发病率似乎在上升，原因不明，在美国估计为每10万人中有0.32例。
方法
本文将综述目前关于MCC治疗的文献和美国国立综合癌症网络的实践指南。
结果
切缘阴性的MCC切除仍是主要治疗方法。阳性淋巴结疾病应采用颈部清扫术和辅助放疗。高危患者应接受辅助放疗，这可改善肿瘤学结局。化疗的作用尚不清楚，目前仅用于晚期MCC和姑息治疗。
结论
默克尔细胞多瘤病毒（MCPyV）的发现最近对MCC的发病机制产生了影响。建立靶向和免疫治疗方案的研究正在进行中。
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