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[子宫颈神经内分泌分化癌]

[Neuroendocrine differentiated carcinoma of the uterine cervix].

作者信息

Horn L C, Fischer U, Bilek K

机构信息

Institut für Pathologie, Universität Leipzig.

出版信息

Zentralbl Gynakol. 1996;118(12):679-83.

PMID:9082707
Abstract

Cervical neuroendocrine carcinomas (CNC) are rare tumors. The term includes the cervical carcinoid, the small cell (oat-cell) carcinoma and the primitive neuroectodermal tumor (PNET). Between 1979 and 1993 eight CNC out of 788 cervical carcinomas were identified by conventional light microscopy and immunohistochemistry. Three tumors were small cell carcinomas with positive staining for NSE (6/8 tumors) and chromogranin A (2/8). In one case a PNET was diagnosed by identifying rosette like structures and negative immunohistochemistry for neuroendocrine markers. Two patients (including PNET) died of disease 3.1 (1.3 to 4.8) years after diagnosis. The others showed no evidence of disease after a mean follow up to 4.4 years. Three of them got pelvic radiation postoperatively. Four tumors showed foci of squamous cell carcinoma [3] and adenocarcinoma [2]. There is no evidence, that these foci influence the prognosis on CNC. Therefore, it is important to recognize the neuroendocrine component, as this type of carcinoma requires special therapeutic considerations. The authors favour the metaplastic origin of CNC from a multipotent (endocervical) stem cell.

摘要

宫颈神经内分泌癌(CNC)是罕见肿瘤。该术语包括宫颈类癌、小细胞(燕麦细胞)癌和原始神经外胚层肿瘤(PNET)。1979年至1993年间,通过传统光学显微镜和免疫组织化学方法,在788例宫颈癌中识别出8例CNC。3例为小细胞癌,NSE染色阳性(8例中的6例),嗜铬粒蛋白A染色阳性(8例中的2例)。1例通过识别菊形团样结构及神经内分泌标志物免疫组化阴性诊断为PNET。2例患者(包括PNET)在诊断后3.1(1.3至4.8)年死于疾病。其他患者在平均随访4.4年后无疾病证据。其中3例术后接受盆腔放疗。4例肿瘤显示有鳞状细胞癌灶[3]和腺癌灶[2]。没有证据表明这些病灶会影响CNC的预后。因此,识别神经内分泌成分很重要,因为这类癌需要特殊的治疗考量。作者支持CNC起源于多能(宫颈管内膜)干细胞的化生学说。

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