Xu N W, Ji Y J, Zhuo H D, Wang Y J, Qi X P, Xue J M, An Y F, Suo L M, Zhao C Q
Second School of Clinical Medicine, Shanxi Medical University, Taiyuan 030001, China Department of Otorhinolaryngology Head Neck Surgery, the Second Hospital, Shanxi Medical University, Key Research Laboratory of Airway Neuroimmunology, Taiyuan 030001, China.
Department of Otorhinolaryngology Head Neck Surgery, the Second Hospital, Shanxi Medical University, Key Research Laboratory of Airway Neuroimmunology, Taiyuan 030001, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Nov 7;57(11):1334-1338. doi: 10.3760/cma.j.cn115330-20220328-00138.
To investigate the clinical and pathological features, treatments and prognosis of laryngeal neuroendocrine carcinoma (LNEC). We conducted the retrospective analysis of the clinical data of 12 patients with LNEC admitted to the Department of Otorhinolaryngology Head and Neck Surgery, Second Hospital of Shanxi Medical University from May 2014 to December 2021, including 9 males and 3 females, aged 50-77 years. There were 4 cases of typical carcinoid tumour (highly differentiated), 5 cases of atypical carcinoid tumour (moderately differentiated) and 3 cases of neuroendocrine small cell carcinoma (hypofractionated). The clinical features, diagnosis, treatment and prognosis of LNEC were analysed. The clinical manifestations of LNEC varied according to the tumour type but did not correlate with the pathological types. The supraglottic type was characterized by sore throat, foreign body sensation in the pharynx, coughing, obstructive sensation when eating and choking on water. The treatments were determined according to the pathological types, lesion location and invasion scope. Of 12 patients 4 underwent horizontal partial laryngectomy plus elective lymphatic dissection plus postoperative radiotherapy/chemotherapy, 4 underwent vertical partial laryngectomy (3 of them with cervical lymphatic dissection), 3 underwent supported laryngoscopic plasma laryngectomy for laryngeal cancer, and 1 abandoned for treatment. With the follow-up of 8 -78 months, 5 patients were alive, 1 died from chemotherapy reactions, 3 died from other diseases, 1 died from lung metastasis, 1 died from lung infection and 1 was lost to follow-up. LNEC is clinically rare, the clinical manifestations are less specificity, diagnosis relies on pathological and immunohistochemical examinations, and treatment modalities and prognoses are closely related to the pathological subtypes of LNEC.
探讨喉神经内分泌癌(LNEC)的临床病理特征、治疗方法及预后。我们对2014年5月至2021年12月在山西医科大学第二医院耳鼻咽喉头颈外科收治的12例LNEC患者的临床资料进行回顾性分析,其中男性9例,女性3例,年龄50 - 77岁。典型类癌肿瘤(高分化)4例,非典型类癌肿瘤(中分化)5例,神经内分泌小细胞癌(低分化)3例。分析LNEC的临床特征、诊断、治疗及预后。LNEC的临床表现因肿瘤类型而异,但与病理类型无关。声门上型表现为咽痛、咽部异物感、咳嗽、进食时有梗阻感及饮水呛咳。治疗根据病理类型、病变部位及侵犯范围确定。12例患者中,4例行水平部分喉切除术加选择性淋巴结清扫术加术后放疗/化疗,4例行垂直部分喉切除术(其中3例加颈部淋巴结清扫术),3例行支撑喉镜下等离子体喉癌切除术,1例放弃治疗。随访8 - 78个月,5例存活,1例死于化疗反应,3例死于其他疾病,1例死于肺转移,1例死于肺部感染,1例失访。LNEC临床罕见,临床表现特异性较差,诊断依赖病理及免疫组化检查,治疗方式及预后与LNEC的病理亚型密切相关。