山东大学耳鼻喉眼学报 ›› 2025, Vol. 39 ›› Issue (2): 79-86.doi: 10.6040/j.issn.1673-3770.0.2024.369

• 论著 • 上一篇    

喉神经内分泌肿瘤26例临床病理特征及生存分析

谢枫1,许贞菊1,吴策1,刘杰1,臧传善1,张龙宵2,韩敏1   

  1. 青岛大学附属医院 1.耳鼻咽喉头颈外科;
    2.病理科, 山东 青岛 266003
  • 发布日期:2025-03-26
  • 通讯作者: 韩敏. E-mail:hanminjn@163.com

Clinicopathologic and survival analysis of laryngeal neuroendocrine neoplasm in 26 cases

XIE Feng1, XU Zhenju1, WU Ce1, LIU Jie1, ZANG Chuanshan1, ZHANG Longxiao2, HAN Min1   

  1. 1. Department of Otorhinolaryngology & Head and Neck Surgery;
    2. Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong, China
  • Published:2025-03-26

摘要: 目的 探讨喉神经内分泌肿瘤的临床病理特征并进行生存分析,以期为临床诊疗提供有益的参考。 方法 回顾性收集26例喉神经内分泌肿瘤患者的临床资料并对其临床病理特征并进行总结,使用Kaplan-Meier分析和Cox风险回归模型对喉神经内分泌肿瘤进行生存分析。 结果 分化良好的喉神经内分泌肿瘤最为多见,BMI、肿瘤大小和Ki-67标记指数在分化程度不同的喉神经内分泌肿瘤患者间差异有统计学意义。喉神经内分泌肿瘤的总体5年总生存率仅为43.2%,预后较差。多因素分析显示,淋巴结转移、高Ki-67标记指数和远处转移是影响患者总生存率的独立危险因素。 结论 不同分化程度的喉神经内分泌肿瘤具有不同的临床病理特征。淋巴结转移、Ki-67标记指数和远处转移是影响总生存率重要因素。

关键词: 喉癌, 神经内分泌肿瘤, 生存分析, Ki-67

Abstract: Objective The objective of this study was to investigate the clinicopathologic characteristics of laryngeal neuroendocrine neoplasm and to conduct a survival analysis, with the aim of providing a valuable reference for clinical diagnosis and treatment. Methods A retrospective study of clinical data was conducted for a total of 26 patients diagnosed laryngeal neuroendocrine neoplasm. The clinical data was then grouped for the purpose of comparison. Survival analysis was perfoemed using both Kaplan-Meier analysis and Cox proportional-hazards regression models. Results Laryngeal neuroendocrine neoplasm(LNN)was most prevalent in the well-differentiated cases, and significant disparities were observed between the two groups with respect to the body mass index(BMI), tumour size, and Ki-67 labeling index. The 5-year overall survival rate for LNN was 43.2%, signifying a poor prognosis. Multifactorial analysis showed that lymph node metastasis, high Ki-67 labeling index and distant metastasis were independent risk factors affecting patients' overall survival rate. Conclusion Laryngeal neuroendocrine neoplasms manifesting diverse differentiation patterns exhibit distinct characteristics. The most significant factors affecting the overall survival rate are the Ki-67 labeling index, the presence of distant metastasis, and lymph node metastasis.

Key words: Laryngeal cancer, Neuroendocrine neoplasm, Survival analysis, Ki-67

中图分类号: 

  • R739.65
[1] Yuan CC, Jiao F, Zhai CW, et al. Application of INSM1 in diagnosis and grading of laryngeal neuroendocrine carcinoma[J]. Laryngoscope, 2021, 131(10): E2662-E2668. doi:10.1002/lary.29554
[2] Mete O, Wenig BM. Update from the 5th edition of the world health organization classification of head and neck tumors: overview of the 2022 WHO classification of head and neck neuroendocrine neoplasms[J]. Head Neck Pathol, 2022, 16(1): 123-142. doi: 10.1007/s12105-022-01435-8
[3] Wang Y, Liu DL, She CP. Clinical diagnosis and treatment of primary laryngeal neuroendocrine carcinoma[J]. Ear Nose Throat J, 2023: 1455613231155853. doi:10.1177/01455613231155853
[4] Ghosh R, Dutta R, Dubal PM, et al. Laryngeal neuroendocrine carcinoma: a population-based analysis of incidence and survival[J]. Otolaryngol Head Neck Surg, 2015, 153(6): 966-972. doi:10.1177/0194599815594386
[5] 毛泽凡, 陈曦, 程雷. 喉神经内分泌癌的研究进展[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 114-119. doi:10.6040/j.issn.1673-3770.1.2021.152 MAO Zefan, CHEN Xi, CHENG Lei. Research advances in neuroendocrine carcinoma of the larynx[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(4): 114-119. doi:10.6040/j.issn.1673-3770.1.2021.152
[6] Amin MB, Greene FL, Edge SB, et al. AJCC Cancer Staging Manual Eighth Edition[M]. Berlin: Springer Nuture, 2016: 149-161
[7] van der Laan TP, Plaat BE, van der Laan BF, et al. Clinical recommendations on the treatment of neuroendocrine carcinoma of the larynx: A meta-analysis of 436 reported cases[J]. Head Neck, 2015, 37(5):707-15. doi: 10.1002/hed.23666
[8] Di Credico G, Polesel J, Maso LD, et al. Alcohol drinking and head and neck cancer risk: the joint effect of intensity and duration[J]. Br J Cancer, 2020, 123(9): 1456-1463. doi:10.1038/s41416-020-01031-z
[9] Chung EJ, Baek SK, Kwon SY, et al. Moderately differentiated neuroendocrine carcinoma of the larynx[J]. Clin Exp Otorhinolaryngol, 2008, 1(4): 217-220. doi:10.3342/ceo.2008.1.4.217
[10] 张洋, 段翰源, 李祖飞, 等. 25例喉神经内分泌癌的诊治与临床分析[J]. 肿瘤预防与治疗, 2019, 32(7): 607-611. doi:10.3969/j.issn.1674-0904.2019.07.009 ZHANG Yang, DUAN Hanyuan, LI Zufei, et al. Diagnosis, treatment and clinical analysis of 25 cases of laryngeal neuroendocrine carcinoma[J]. Journal of Cancer Control and Treatment, 2019, 32(7): 607-611. doi:10.3969/j.issn.1674-0904.2019.07.009
[11] 魏东敏, 李文明, 曹晟达, 等. 声门上型喉癌184例手术治疗分析[J]. 中华耳鼻咽喉头颈外科杂志, 2019, 54(5): 334-338. doi:10.3760/cma.j.issn.1673-0860.2019.05.004 WEI Dongmin, LI Wenming, CAO Shengda, et al. Surgical treatment in 184 patients with supraglottic carcinoma at a single institute[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2019, 54(5): 334-338. doi:10.3760/cma.j.issn.1673-0860.2019.05.004
[12] 董春光, 李利, 韩加辉, 等. 经口CO2激光治疗侵及前连合的早期声门型喉癌22例[J]. 中国耳鼻咽喉头颈外科, 2022, 29(10): 613-616. doi:10.16066/j.1672-7002.2022.10.001 DONG Chunguang, LI Li, HAN Jiahui, et al. Treatment of early glottic laryngeal carcinoma involving anterior commissure with transoral CO2 laser[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2022, 29(10): 613-616. doi:10.16066/j.1672-7002.2022.10.001
[13] 鞠骏, 王嘉森, 侯思源, 等. 早期声门型喉癌385例内镜手术疗效的回顾性研究[J]. 中华耳鼻咽喉头颈外科杂志, 2024, 59(10): 1020-1028. doi: 10.3760/cma.j.cn115330-20240605-00338 JU Jun, WANG Jiasen, HOU Siyuan, et al. A retrospective study on the prognosis of endoscopic surgery for 385 early glottic cancer patients[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2024, 59(10): 1020-1028. doi: 10.3760/cma.j.cn115330-20240605-00338
[14] Becht R, Kie bowski K, ychowska J, et al. Small cell carcinoma with neuroendocrine differentiation of subglottic larynx-a case report[J]. Front Oncol, 2023, 13: 1222418. doi:10.3389/fonc.2023.1222418
[15] Strojan P, Hernandez-Prera JC, Beitler JJ, et al. Small cell and large cell neuroendocrine carcinoma of the larynx: a comparative analysis[J]. Cancer Treat Rev, 2019, 78: 42-51. doi:10.1016/j.ctrv.2019.08.002
[16] Sahin S, Erdem GU, Karatas F, et al. The association between body mass index and immunohistochemical subtypes in breast cancer[J]. Breast, 2017, 32: 227-236. doi:10.1016/j.breast.2016.09.019
[17] Te Riele RM, Dronkers EC, Wieringa MH, et al. Influence of Anemia and BMI on prognosis of laryngeal squamous cell carcinoma: Development of an updated prognostic model[J]. Oral Oncol, 2018, 78: 25-30. doi:10.1016/j.oraloncology.2018.01.001
[18] Zhang ZX, Yan XL, Lu Y, et al. The prognostic impact of BMI on colorectal cancer is stratified by tumor location[J]. Front Oncol, 2022, 12: 987518. doi:10.3389/fonc.2022.987518
[19] Duprez F, Berwouts D, De Neve W, et al. Distant metastases in head and neck cancer[J]. Head Neck, 2017, 39(9): 1733-1743. doi:10.1002/hed.24687
[20] Reticker-Flynn NE, Zhang WR, Belk JA, et al. Lymph node colonization induces tumor-immune tolerance to promote distant metastasis[J]. Cell, 2022, 185(11): 1924-1942.e23. doi:10.1016/j.cell.2022.04.019
[21] Molteni G, Nocini R, Mattioli F, et al. Impact of lymph node ratio and number of lymph node metastases on survival and recurrence in laryngeal squamous cell carcinoma[J]. Head Neck, 2023, 45(9): 2274-2293. doi:10.1002/hed.27471
[22] Wunschel M, Neumeier M, Utpatel K, et al. Staging more important than grading Evaluation of malignancy grading, depth of invasion, and resection margins in oral squamous cell carcinoma[J]. Clin Oral Investig, 2021, 25(3): 1169-1182. doi:10.1007/s00784-020-03421-2
[23] Bal M, Sharma A, Rane SU, et al. Neuroendocrine neoplasms of the larynx: a clinicopathologic analysis of 27 neuroendocrine tumors and neuroendocrine carcinomas[J]. Head Neck Pathol, 2022, 16(2): 375-387. doi:10.1007/s12105-021-01367-9
[24] 徐诺文, 冀永进, 卓荷荻, 等. 喉神经内分泌癌12例临床分析[J]. 中华耳鼻咽喉头颈外科杂志, 2022, 57(11): 1334-1338. doi:10.3760/cma.j.cn115330-20220328-00138 XU Nuowen, JI Yongjin, ZHUO Hedi, et al. Clinical analysis of 12 cases of laryngeal neuroendocrine carcinoma[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2022, 57(11): 1334-1338. doi:10.3760/cma.j.cn115330-20220328-00138
[25] Rindi G, Klimstra DS, Abedi-Ardekani B, et al. A common classification framework for neuroendocrine neoplasms: an International Agency for Research on Cancer(IARC)and World Health Organization(WHO)expert consensus proposal[J]. Mod Pathol, 2018, 31(12): 1770-1786. doi:10.1038/s41379-018-0110-y
[26] La RS. Diagnostic, prognostic, and predictive role of Ki67 proliferative index in neuroendocrine and endocrine neoplasms: past, present, and future[J]. Endocr Pathol, 2023, 34(1): 79-97. doi:10.1007/s12022-023-09755-3
[27] Gioacchini FM, Alicandri-Ciufelli M, Magliulo G, et al. The clinical relevance of Ki-67 expression in laryngeal squamous cell carcinoma[J]. Eur Arch Otorhinolaryngol, 2015, 272(7): 1569-1576. doi:10.1007/s00405-014-3117-0
[28] Xu QQ, Li QJ, Xu Z, et al. Prognostic value of the immunohistochemical score based on four markers in head and neck squamous cell carcinoma[J]. Front Immunol, 2023, 14: 1076890. doi:10.3389/fimmu.2023.1076890
[29] Cong R, Kong FF, Ma J, et al. Combination of preoperative neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and monocyte-lymphocyte ratio: a superior prognostic factor of endometrial cancer[J]. BMC Cancer, 2020, 20(1): 464. doi:10.1186/s12885-020-06953-8
[30] Zhao YH, Qin JB, Qiu ZF, et al. Prognostic role of neutrophil-to-lymphocyte ratio to laryngeal squamous cell carcinoma: a meta-analysis[J]. Braz J Otorhinolaryngol, 2022, 88(5): 717-724. doi:10.1016/j.bjorl.2020.09.015
[1] 曲翔宇,朱晗,柳忠禄,牟亚魁,郭文涛,张华. 会厌舌瓣在喉癌声门上缺损修复术中的应用[J]. 山东大学耳鼻喉眼学报, 2025, 39(1): 77-84.
[2] 刘萍,顾子君,储婷,陈曦,程雷. 高流量呼吸湿化治疗仪在喉癌术后人工气道非机械通气患者中的应用效果研究[J]. 山东大学耳鼻喉眼学报, 2024, 38(5): 31-36.
[3] 王靖淞,余灿,张西,邓启成,谢卓良,赵锐,温蓓,刘海. KRT4在喉癌及癌旁正常黏膜组织中的表达及临床意义[J]. 山东大学耳鼻喉眼学报, 2024, 38(3): 12-17.
[4] 孙洁,肖旭平,李云秋. 鼻腔低级别非肠型腺癌1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 26-30.
[5] 张竹萍,叶琪,郭蓓,林凌. 叶酸受体阳性循环肿瘤细胞检测在喉鳞状细胞癌诊断中的应用价值[J]. 山东大学耳鼻喉眼学报, 2023, 37(5): 50-53.
[6] 张西,邓启成,张震,程瑶,王靖淞,赵锐,刘海. 营养支持对喉癌术后咽瘘影响的Meta分析[J]. 山东大学耳鼻喉眼学报, 2023, 37(3): 51-59.
[7] 徐翀,王晓亭,易红良. 单细胞测序分析喉癌及其微环境代谢相关靶基因[J]. 山东大学耳鼻喉眼学报, 2023, 37(2): 33-38.
[8] 黄恒丰,马鲲鹏,杨迪,张丽君,张盛林. miR-181b-5P和EPB41L3蛋白在喉癌中的表达及临床意义[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 41-46.
[9] 李利杰,田秀芬. CO2激光联合低温等离子治疗早期声门型喉癌40例[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 79-85.
[10] 王媚 李志海. 喉癌干细胞:克服多药耐药性的潜在治疗靶点[J]. 山东大学耳鼻喉眼学报, 2022, 36(4): 120-128.
[11] 王晓亭,陈正侬,易红良. 利用RNA-seq探讨谷氨酰胺剥夺对喉癌细胞转录组的影响[J]. 山东大学耳鼻喉眼学报, 2022, 36(2): 26-31.
[12] 冯成敏,敬一丹,刘海,王冰. 咽喉部鳞状细胞癌细胞系[J]. 山东大学耳鼻喉眼学报, 2021, 35(6): 113-124.
[13] 李艳杰, 贾建,杨萍,万保罗. 肿瘤异常蛋白在喉癌临床诊断中的价值研究[J]. 山东大学耳鼻喉眼学报, 2021, 35(5): 70-74.
[14] 陈国平,傅敏仪,叶飞,徐建慧. 早期声门型喉癌钬激光与CO2激光手术对比研究[J]. 山东大学耳鼻喉眼学报, 2021, 35(4): 8-11.
[15] 吴允刚,张辉,孙聚兴,刘涛,王彩华,杨欣欣,马林祥,李笑颖,庞太忠,李晓瑜. 环甲膜联合喉室入路切除T1B声门型喉癌临床疗效分析[J]. 山东大学耳鼻喉眼学报, 2021, 35(4): 30-34.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!