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默克尔细胞癌的临床病理特征及预后:韩国一项单中心回顾性研究

Clinicopathological characteristics and prognosis of Merkel cell carcinoma: a single-center retrospective study in Korea.

作者信息

Moon Ik Jun, Na Hyungmin, Cho Hye Soo, Won Chong Hyun, Chang Sung Eun, Lee Mi Woo, Lee Woo Jin

机构信息

Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-Gil, Songpa-gu, Seoul, 05505, South Korea.

出版信息

J Cancer Res Clin Oncol. 2023 Sep;149(12):10065-10074. doi: 10.1007/s00432-023-04932-7. Epub 2023 Jun 1.

Abstract

BACKGROUND

Merkel cell carcinoma (MCC) is an aggressive neuroendocrine tumor of the skin with high mortality. However, its clinical characteristics in Asian patients remain uncertain owing to its low incidence.

OBJECTIVE

To analyze the clinicopathological features of MCC and identify factors associated with its prognosis.

METHODS

The medical records of 62 patients with MCC were retrospectively reviewed. Data on clinical features, survival outcomes, prognostic factors, histopathology and immunohistochemical profile of the patients were collected and analyzed. Merkel cell polyomavirus status was evaluated using immunohistochemistry.

RESULTS

The incidence of MCC significantly increased over time. The mean duration of follow-up was 51.2 months, with an overall 5-year survival of 80.6%. More female patients with MCC were identified than male patients (1.3:1). Approximately half of the patients had stage I disease at the time of initial presentation. The primary tumor was frequently located in the lower extremities (40.3%), followed by the head and neck (32.3%), upper extremities (22.6%), and the trunk (4.8%). Male sex was associated with poorer overall survival (p = 0.003). Post-resection adjuvant radiotherapy significantly improved the overall survival (p = 0.023). Sentinel lymph node biopsy during surgery ameliorated the progression-free survival (p = 0.036) in patients with stage I or II cancer. Lymphovascular and perineural invasion were associated with a poor prognosis. Old age, immunohistochemical profiles, and Merkel cell polyomavirus-positivity were not associated with prognosis.

CONCLUSION

Post-surgical adjuvant radiotherapy and sentinel lymph node biopsy significantly improve the course of MCC.

摘要

背景

默克尔细胞癌(MCC)是一种侵袭性皮肤神经内分泌肿瘤,死亡率高。然而,由于其发病率低,其在亚洲患者中的临床特征仍不明确。

目的

分析MCC的临床病理特征并确定与其预后相关的因素。

方法

回顾性分析62例MCC患者的病历。收集并分析患者的临床特征、生存结局、预后因素、组织病理学和免疫组化特征。采用免疫组化评估默克尔细胞多瘤病毒状态。

结果

MCC的发病率随时间显著增加。平均随访时间为51.2个月,5年总生存率为80.6%。确诊的女性MCC患者多于男性患者(比例为1.3:1)。约一半患者初诊时为I期疾病。原发肿瘤常位于下肢(40.3%),其次是头颈部(32.3%)、上肢(22.6%)和躯干(4.8%)。男性与较差的总生存率相关(p = 0.003)。术后辅助放疗显著提高了总生存率(p = 0.023)。手术期间进行前哨淋巴结活检改善了I期或II期癌症患者的无进展生存率(p = 0.036)。淋巴管和神经周围侵犯与预后不良相关。年龄、免疫组化特征和默克尔细胞多瘤病毒阳性与预后无关。

结论

术后辅助放疗和前哨淋巴结活检显著改善了MCC的病程。

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