Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Dalian Medical University, Dalian, China.
Front Cell Infect Microbiol. 2022 Jul 13;12:916506. doi: 10.3389/fcimb.2022.916506. eCollection 2022.
Cervical SCNEC is a rare and highly malignant invasive tumor. The incidence is low, at less than 5% of all cervical cancers. Moreover, most patients with small cell carcinoma are interrelated with high risk HPV (more familiar HPV 18). Compared to squamous cell carcinoma or adenocarcinoma, patients of cevical SCNEC are more prone to lymph node invasion early, so the clinical manifestation is usually local or distant metastasis. We summarized the clinical features of 19 patients with cervical small cell carcinoma in the Second Affiliated Hospital of Dalian Medical University from 2012 to 2021, and retrospectively analyzed data from 1576 patients in 20 related studies and more than 50 pieces of literature in recent years by searching PubMed, Google schalor, Cochrane Library, Clinicalkey, and other databases. The collected patient data included age, clinical manifestation, TCT, HPV detection, the size and morphology of the tumor, local invasion depth, stage, lymph node status, initial treatment method, tumor-free survival, and so on. The positive rates of CGA, SYN, and CD56 in our cases were high, and NSE was a moderately sensitive index. P16 and Ki67 were the most sensitive, and all patients were positive. We found that multimodal treatment can indeed improve tumor-free survival (DFS), but the prognosis of patients is still very poor. For the early stages, our treatment principles refer to the guidelines of SGO, international gynecological cancer Cooperation (GCIG), and NCCN. We suggest a combination of surgery, radiotherapy, and chemotherapy. However, the general state of advanced patients is poor, whether they can tolerate the operation after neoadjuvant chemotherapy, whether the operation area can remain tumor-free, and whether this treatment will prolong the survival time of patients still need to be further discussed. In order to better prolong the tumor-free survival and prognosis of patients, we need to find gene changes suitable for targeted therapy, so as to complete the clinical application of these treatment methods. Further works are needed to explore more effective therapy for cervical SCNEC.
宫颈小细胞神经内分泌癌是一种罕见且高度恶性的侵袭性肿瘤，发病率低于所有宫颈癌的 5%。此外，大多数小细胞癌患者与高危型 HPV（更熟悉的 HPV 18）有关。与鳞癌或腺癌相比，宫颈 SCNEC 患者更易早期发生淋巴结侵犯，因此临床表现通常为局部或远处转移。我们总结了大连医科大学附属第二医院 2012 年至 2021 年收治的 19 例宫颈小细胞癌患者的临床特征，并通过检索 PubMed、Google Scholar、Cochrane Library、Clinicalkey 等数据库，对 20 项相关研究中的 1576 例患者和近年来 50 多篇文献中的数据进行了回顾性分析。收集的患者数据包括年龄、临床表现、TCT、HPV 检测、肿瘤大小和形态、局部侵犯深度、分期、淋巴结状态、初始治疗方法、无瘤生存等。我们病例中 CGA、SYN 和 CD56 的阳性率较高，NSE 为中度敏感指标。P16 和 Ki67 最敏感，所有患者均为阳性。我们发现多模态治疗确实可以提高无瘤生存（DFS），但患者的预后仍然非常差。对于早期，我们的治疗原则参考 SGO、国际妇科癌症合作组织（GCIG）和 NCCN 的指南。我们建议手术、放疗和化疗相结合。然而，晚期患者的一般状况较差，他们能否耐受新辅助化疗后的手术，手术区域能否保持无肿瘤，以及这种治疗是否会延长患者的生存时间，仍需进一步讨论。为了更好地延长患者的无瘤生存和预后，我们需要寻找适合靶向治疗的基因变化，以便将这些治疗方法应用于临床。需要进一步的工作来探索更有效的宫颈 SCNEC 治疗方法。
