Liu Yun, Li Meirong, Liu Yan, Wan Yu, Yang Bo, Li Dan, Wang Shaohua
Department of Pathology, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, 646000, People's Republic of China.
Department of Pathology, Deyang People's Hospital, Deyang, Sichuan Province, 618099, People's Republic of China.
Onco Targets Ther. 2024 Jul 8;17:557-565. doi: 10.2147/OTT.S460465. eCollection 2024.
BACKGROUND/AIMS: There are currently few reports describing the liquid-based cytological characteristics of small cell neuroendocrine carcinoma of the cervix. This study aimed to retrospectively analyze these features to reduce missed or misdiagnosis.
A total of 11 patients with histologically diagnosed small cell carcinoma of the cervix from three hospitals between 2017 and 2023 were included in this study. The cytological morphology of small cell carcinoma of the cervix and causes of missed or misdiagnosis were analyzed and summarized through a review of clinical data, liquid-based cytology, histology, immunohistochemistry, and human papillomaviruses (HPV) test results.
In this study, the positivity rate of preliminary cytological screening was 63.6% (7/11); however, no cases were accurately diagnosed as small cell carcinoma of the cervix. A total of 36.4% (4/11) of small cell carcinoma of the cervix cases were cytologically negative; retrospective cytology found that two of these were false negatives. The main cytological features of small cell carcinoma of the cervix were summarized. Most of the liquid-based cytology smear cells were dense, and almost all cases showed clustered and scattered cytoplasm-scanty tumor cells. The tumor cells were all deeply stained and relatively consistent small cells. Most cases showed typical nuclear molding, chromatin stippling, and no obvious nucleoli. Mild nuclear smears, nuclear fragments, and mitotic figures were seen in most cases.
Liquid-based cytology has a high rate of missed diagnosis and misdiagnosis in small cell carcinoma of the cervix. This study confirms that reviewing cytology results can effectively reduce this proportion and that increasing understanding of small cell carcinoma of the cervix morphology is conducive to improving the cytology-based diagnosis rate.
背景/目的：目前关于宫颈小细胞神经内分泌癌液基细胞学特征的报道较少。本研究旨在回顾性分析这些特征以减少漏诊或误诊。
本研究纳入了2017年至2023年间来自三家医院的11例经组织学诊断为宫颈小细胞癌的患者。通过回顾临床资料、液基细胞学、组织学、免疫组化及人乳头瘤病毒（HPV）检测结果，分析并总结宫颈小细胞癌的细胞学形态及漏诊或误诊原因。
本研究中，初步细胞学筛查的阳性率为63.6%（7/11）；然而，无一例被准确诊断为宫颈小细胞癌。共有36.4%（4/11）的宫颈小细胞癌病例细胞学检查为阴性；回顾性细胞学检查发现其中两例为假阴性。总结了宫颈小细胞癌的主要细胞学特征。大多数液基细胞学涂片细胞密集，几乎所有病例均可见成簇和散在的胞质稀少的肿瘤细胞。肿瘤细胞均为深染且相对一致的小细胞。大多数病例可见典型的核型、染色质颗粒状，且无明显核仁。大多数病例可见轻度核涂片、核碎片及有丝分裂象。
液基细胞学对宫颈小细胞癌的漏诊和误诊率较高。本研究证实复查细胞学结果可有效降低这一比例，且增加对宫颈小细胞癌形态学的认识有助于提高基于细胞学的诊断率。
