Chen Zhi, Liu Qingquan, Chen Ruibao, Liu Zhuo, Li Mingchao, Ling Qing, Wu Licheng, Yang Jun, Liu Xiaming, Wang Tao, Hu Zhiquan, Guo Xiaoling, Wang Shaogang, Yang Weiming, Liu Jihong
Department of Urology, Huazhong University of Science and Technology, Wuhan, 430030, China.
Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
World J Surg Oncol. 2017 Jan 26;15(1):33. doi: 10.1186/s12957-016-1079-y.
Small cell carcinoma of the bladder (SCCB) is a kind of rare and highly aggressive tumor that is present in an advanced stage and has a propensity for early metastasis. The main presenting symptom of SCCB is hematuria. Surgery, chemotherapy, and radiotherapy, either alone or as a part of combined therapy, have been used as the treatment. The aim of this study is to present our experience with 9 SCCB patients who were treated with different modalities and to share the findings upon reviewing the literatures for patients with SCCB reported in 56 literatures in Chinese.
We retrospectively evaluated 9 patients with SCCB from February 1980 to January 2014 in Tongji Hospital, Huazhong University of Science and Technology. The general characteristics, clinical manifestations, the pathological and immunohistochemical characteristics, treatment options, and prognostication in those eligible manuscripts were analyzed. In order to gain a better understanding of the clinical features of SCCB, another 119 cases reported in 56 articles were reviewed together (from January 1979 to March 2014). And a retrospective analysis was performed.
All the 9 cases in Tongji Hospital were successfully operated, and the tissue samples were sent for pathological examination. All the tumor tissues contained small cell carcinoma components. 4 cases coexisted with other histologic types of bladder cancers, and 2 out of the 9 cases had three different cell components. All the patients had muscle invasion, and 4 cases showed lymph nodes metastasis, 3 cases showed invasion of neighboring structures (seminal vesicle or uterus), and 1 case was highly suspected of liver metastasis. Immunohistochemistry results showed that PCK, Syn, NSE, and CD56 were all positive, but LCA was negative. After operations, 3 patients underwent chemotherapy and only 1 patient received postoperative radiotherapy. Patients were followed up, ranging from 3 to 84 months and the median survival time was 33 months. The leading cause of death was tumor recurrence or metastasis, while 2 patients are still alive. According to the published literature, the pathological stage, immunohistochemical markers, and survival curves of all the 128 cases were also retrospectively analyzed.
SCCB is different from transitional cell carcinoma (TCC) of the bladder. It has its unique cytology, immunohistochemistry, and ultrastructural features. Its diagnosis relies on pathological examination and immunohistochemistry. The current main treatment for SCCB is surgery combined with chemotherapy. Since the disease develops early metastasis easily, the overall prognosis of this cancer is poor. Further research need to clarify the molecular pathogenesis so that novel therapies can be developed for this rare cancer.
膀胱小细胞癌（SCCB）是一种罕见且侵袭性很强的肿瘤，多处于晚期，易于早期转移。SCCB的主要症状是血尿。手术、化疗和放疗，单独使用或作为联合治疗的一部分，均已被用作治疗手段。本研究的目的是介绍我们对9例接受不同治疗方式的SCCB患者的治疗经验，并通过回顾56篇中文文献中报道的SCCB患者的研究结果进行分享。
我们回顾性评估了1980年2月至2014年1月在华中科技大学同济医院的9例SCCB患者。分析了符合条件的文献中的一般特征、临床表现、病理和免疫组化特征、治疗选择及预后情况。为了更好地了解SCCB的临床特征，我们还一起回顾了56篇文章中报道的另外119例病例（1979年1月至2014年3月），并进行了回顾性分析。
同济医院的9例患者均成功接受了手术，并将组织样本送去做病理检查。所有肿瘤组织均含有小细胞癌成分。4例合并有其他组织学类型的膀胱癌，9例中有2例含有三种不同的细胞成分。所有患者均有肌层浸润，4例有淋巴结转移，3例有邻近结构（精囊或子宫）侵犯，1例高度怀疑有肝转移。免疫组化结果显示，细胞角蛋白（PCK）、突触素（Syn）、神经元特异性烯醇化酶（NSE）和CD56均为阳性，但白细胞共同抗原（LCA）为阴性。术后，3例患者接受了化疗，只有1例患者接受了术后放疗。对患者进行随访，时间为3至84个月，中位生存时间为33个月。死亡的主要原因是肿瘤复发或转移，仍有2例患者存活。根据已发表的文献，对所有128例患者的病理分期、免疫组化标志物及生存曲线也进行了回顾性分析。
SCCB与膀胱移行细胞癌（TCC）不同。它有其独特的细胞学、免疫组化及超微结构特征。其诊断依赖于病理检查和免疫组化。目前SCCB的主要治疗方法是手术联合化疗。由于该疾病易于早期转移，这种癌症的总体预后较差。需要进一步研究以阐明分子发病机制，从而为这种罕见癌症开发新的治疗方法。
