Gu Yu-Mei, Liang Xiao-Long, Zhang Yun-Gang, Zhao Hong-Ying, Jin Mu-Lan, Li Xue, Lu Jun
Department of Pathology,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2023 Jun;45(3):429-435. doi: 10.3881/j.issn.1000-503X.15514.
Objective To investigate the clinicopathological features,immunohistochemical features,diagnosis,and relationship with sporadic prostate cancer in primary small cell neuroendocrine carcinoma of the bladder. Methods We retrospectively analyzed the clinical characteristics of 12 patients with primary small cell neuroendocrine carcinoma of the bladder diagnosed at Beijing Chao-Yang Hospital affiliated to Capital Medical University from January 2013 to September 2022.The histological features of primary small cell neuroendocrine carcinoma of the bladder were re-evaluated by two pathologists according to the 2022 revision of the World Health Organization Classification of Tumors of the Urinary System and Male Genital Organs.Electronic medical records were retrieved,and telephone follow-up was conducted from the time of histopathological diagnosis to the death or the end of the last follow-up until January 31,2023. Results The 12 patients include 7 patients in pT3 stage and 1 patient in pT4 stage.Eight patients were complicated with other types of tumors,such as high-grade urothelial carcinoma of the bladder and squamous cell carcinoma.Five patients had sporadic prostate cancer.Immunohistochemical staining showed that 12 (100.0%),10 (83.3%),and 8 (66.7%) patients were tested positive for CD56,Syn,and CgA,respectively.The Ki67 proliferation index ranged from 80% to 90%.Five patients with urothelial carcinoma were tested positive for CK20,GATA3,and CK7.P504S was positive in all the 5 patients with prostate cancer,while P63 and 34βE12 were negative.The follow-up of the 12 patients lasted for 3-60 months.Eight of these patients died during follow-up,with the median survival of 15.5 months.Four patients survived. Conclusions Primary small cell neuroendocrine carcinoma of the bladder is a rare urological tumor with high aggressiveness and poor prognosis.In male patients with bladder prostatectomy,all prostate tissue should be sampled.If prostate cancer is detected,the prostate-specific antigen level should be monitored.
目的 探讨膀胱原发性小细胞神经内分泌癌的临床病理特征、免疫组化特征、诊断以及与散发性前列腺癌的关系。方法 回顾性分析2013年1月至2022年9月在首都医科大学附属北京朝阳医院确诊的12例膀胱原发性小细胞神经内分泌癌患者的临床特征。由两名病理科医生根据2022年版《世界卫生组织泌尿系统及男性生殖器官肿瘤分类》重新评估膀胱原发性小细胞神经内分泌癌的组织学特征。检索电子病历，并从组织病理学诊断时起进行电话随访，直至死亡或最后一次随访结束（截至2023年1月31日）。结果 12例患者中，pT3期7例，pT4期1例。8例患者合并其他类型肿瘤，如膀胱高级别尿路上皮癌和鳞状细胞癌。5例患者患有散发性前列腺癌。免疫组化染色显示，12例（100.0%）、10例（83.3%）和8例（66.7%）患者的CD56、Syn和CgA分别呈阳性。Ki67增殖指数为80%至90%。5例尿路上皮癌患者的CK20、GATA3和CK7呈阳性。5例前列腺癌患者的P504S均为阳性，而P63和34βE12均为阴性。12例患者的随访时间为3至60个月。其中8例患者在随访期间死亡，中位生存期为15.5个月。4例患者存活。结论 膀胱原发性小细胞神经内分泌癌是一种罕见的泌尿系统肿瘤，侵袭性高，预后差。在接受膀胱前列腺切除术的男性患者中，应采集所有前列腺组织样本。如果检测到前列腺癌，应监测前列腺特异性抗原水平。
