背景:起源于子宫内膜的神经内分泌癌(NEC)很少见,关于其诊断和优化管理的知识有限。在这项研究中,我们介绍了11例子宫内膜NEC患者的经验,旨在为临床实践提供指导。
方法:我们回顾性收集了临床,病态,和2011年1月至2023年7月在郑州大学第一附属医院治疗的11例子宫内膜NEC患者的治疗资料。临床病理特征,对这些患者的治疗和预后进行分析。
结果:患者的中位年龄为55.0(39.0-64.0)岁,中位肿瘤大小为40.0(33.0~60.0)mm。不规则阴道出血是11例患者中有10例最常见的症状,而11例患者中只有2例发生代谢综合征。11名患者中有6名在早期被诊断。在患者中,6例诊断为子宫内膜NEC,而其余患者合并有子宫内膜NEC和其他非NEC子宫内膜癌。所有患者都接受了手术,除了因多发转移仅接受化疗的患者。手术后,对5例患者进行了辅助化疗,3例患者给予化疗联合放疗,2例患者未接受任何辅助治疗。共有10例患者完成随访,中位随访时间为51.0(14.3-81.0)个月。不幸的是,2例患者死于该疾病。
结论:源自子宫内膜的NECs可能不受代谢紊乱的影响。这些肿瘤的术前诊断具有挑战性。管理子宫内膜NEC的主要方法可以是以手术为中心的多模式治疗。
BACKGROUND: Neuroendocrine carcinoma (NEC) originating from the endometrium is rare, and there is limited knowledge regarding its diagnosis and optimal management. In this study, we present our experience with 11 patients with endometrial NEC, aiming to provide guidance for clinical practice.
METHODS: We retrospectively collected the clinical, pathological, and treatment data of 11 patients with endometrial NEC who were treated at the First Affiliated Hospital of Zhengzhou University from January 2011 to July 2023. The clinicopathological characteristics, treatment and prognosis of these patients were analyzed.
RESULTS: The median age of the patients was 55.0 (39.0-64.0) years, and the median tumor size was 40.0 (33.0-60.0) mm. Irregular vaginal bleeding was the most common symptom observed in 10 out of 11 patients, while metabolic syndrome occurred in only 2 out of 11 patients. Six out of the 11 patients were diagnosed at an early stage. Among the patients, 6 were diagnosed with endometrial NECs, while the remaining patients had a combination of endometrial NEC and other non-NEC endometrial carcinomas. All patients underwent surgery, except for one who received only chemotherapy due to multiple metastases. After surgery, adjuvant chemotherapy was administered to 5 patients, chemotherapy combined with radiotherapy was given to 3 patients, and 2 patients did not receive any adjuvant therapy. A total of 10 patients completed the follow-up, with a median follow-up time of 51.0 (14.3-81.0) months. Unfortunately, 2 patients died from the disease.
CONCLUSIONS: NECs originating from the endometrium might not be affected by metabolic disorders. Preoperative diagnosis of these tumors was challenging. The primary approach for managing endometrial NEC can be multimodal treatment centered around surgery.