We have analyzed the clinicopathological information of 26 patients with cervical MiNEN.
The median age of onset for cervical MiNEN was 48 years. Macroscopically, polyps and nodules were the main types. The neuroendocrine components included small cell neuroendocrine carcinoma (SCNEC) (14/26 cases), large cell neuroendocrine carcinoma (LCNEC) (10/26 cases), and typical carcinoid (2/26 cases). Non-neuroendocrine components included adenocarcinoma (AC) (12/26, including one case of AC in situ) and squamous cell carcinoma (SC) (10/26) and adeno-squamous cell carcinoma (ASC) (4/26). Of the 16 AC cases, 15 were human papilloma virus (HPV)-associated AC and one was HPV-independent AC. Except for the case of MiNEN with HPV-independent AC, all cases were diffusely and strongly positive for p16 protein. The lympho-vascular space invasion (LVSI) was seen in 17/26 cases, and the components that invade lymphatic vessels were mainly neuroendocrine carcinomas (NECs) (15/17), followed by SC (1/17) and AC (1/17). Ten patients developed LN metastases, including six in combined SCNECs (6/14) and four in combined LCNECs (4/10); the metastatic component was pure NEC in eight cases (8/10) and SC or AC in two cases (2/10).
NEC component is the key factor that determines the clinical behavior and prognosis of cervical MiNEN.
我们分析了26例宫颈MiNEN患者的临床病理信息。
宫颈MiNEN的发病年龄中位数为48岁。宏观上,息肉和结节是主要类型。神经内分泌成分包括小细胞神经内分泌癌(SCNEC)(14/26例),大细胞神经内分泌癌(LCNEC)(10/26例),典型类癌(2/26例)。非神经内分泌成分包括腺癌(AC)(12/26,包括1例原位AC)和鳞状细胞癌(SC)(10/26)和腺鳞状细胞癌(ASC)(4/26)。在16例AC病例中,15个是人乳头瘤病毒(HPV)相关的AC,一个是不依赖HPV的AC。除了MiNEN伴HPV非依赖性AC的病例外,所有病例p16蛋白均呈弥漫性和强阳性。17/26例可见淋巴血管间隙侵犯(LVSI)。侵入淋巴管的成分主要是神经内分泌癌(NECs)(15/17),其次是SC(1/17)和AC(1/17)。10例患者发生LN转移,包括联合SCNEC中的6个(6/14)和联合LCNEC中的4个(4/10);转移成分在8例中为纯NEC(8/10),在2例中为SC或AC(2/10)。
NEC成分是决定宫颈MiNEN临床行为和预后的关键因素。