摘要
目的总结食管小细胞癌(primary esophageal small cell of carcinomas,PESC)发生来源、诊断及综合治疗策略等研究现状。方法检索PubMed及万方数字化期刊检索系统,以"食管小细胞癌、发生来源、诊断、治疗模式和预后"等为关键词,检索2003-01-2014-4的相关文献,共检索到英文文献201条,中文文献308条。纳入标准:1)关于PESC发生来源和病理诊断的研究。2)关于PESC治疗模式和预后的研究。根据纳入标准分析其中33篇。结果肺外小细胞癌以PESC发生率最高,确诊需要靠病理组织学及免疫组化。放化联合治疗在改善局限期PESC患者预后上有一定优势。以化疗为主的综合治疗是延长广泛期PESC的治疗中位生存期的重要方式。肿瘤分期和治疗模式是PESC预后的影响因素。肿瘤分子标志表达水平与PESC治疗疗效与预后关系密切,其中血清神经原特异性烯醇化酶(neuron-specific enolase,NSE)浓度及C反应蛋白水平增高,患者预后可能较差。结论病理学检查并结合神经内分泌标志表达是PESC确诊的重要方式,无论是局限期还是广泛期患者,以化疗为基础的综合治疗模式应被提倡,局限期患者推荐进行放化综合治疗。
OBJECTIVE To summarize the source,diagnosis and treatment modality of primary esophageal small cell carcinoma （PESC）. METHODS The papers were retrieved from the Pubmed and Wanfang index systems from January 2003 to April 2014 with key words of PESC,source,diagnosis, treatment modality and prognostic factors. Totally 201 papers in English and 308 in Chinese were searched. Inclusion criterion ：1）About the source and pathological diagnosis of PESC. 2）About the treatment modality and prognostic factors of PESC. There were 33 papers were selected in this article. RESULTS Extra-pulmonary small cell carcinomas usually occured in esophagus. Definitive diagnosis required histopathology and immunohistochemistry. Chemoradiotherapy has certain advantages in improving the prognosis of PESC with limited stage. For the extensive stage patients,combined therapy based on chemotherapy may improve the median overall survival. Tumor stage and treatment modalities are prognostic factors of esophageal small cell carcinoma. The levels of tumor biological markers are relative to the treatment efficacy and prognosis of PESC. The patients who have high NSE and C-reactive protein expression in the serum may have poor prognosis. CONCLUSIONS Pathological examination combined with neuroendocrine markers is an important method for diagnosing PESC. Combined therapy based on chemotherapy should be recommened for limited stage or extensive stage. Chemoradiotherapy is prior to be selected for patients with limited stage.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2015年第4期315-319,共5页
Chinese Journal of Cancer Prevention and Treatment
关键词
食管小细胞癌
起源
免疫组化
手术
放疗
化疗
综述文献
esophageal small cell carcinomas source immunohistochemistry surgery radiotherapy chemotherapy review
