Merkel细胞瘤一例报告并文献复习

彭向红; 冯奉仪; 周立强

Merkel细胞瘤一例报告并文献复习

中国医学科学院, 中国协和医科大学, 肿瘤医院, 北京 100021

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- 刊出日期: 1998-02-04

Merkal Cell Carcinoma

Peng Xianghang,

Cancer Hospital.Chinese Academy of Medical Sciences.Peking Union Medical College, Beijing 100021

摘要

摘要: 通过一例经手术, 病理证实的Merkel细胞瘤, 复习了相关文献, 对该病的临床特征, 诊断, 治疗原则, 预后因素及分子生物学研究进展进行了讨论。 Merkel细胞瘤是起源于浅表皮肤Merkel细胞的恶性肿瘤, 属于神经内分泌瘤。肿瘤常见于头颈部及四肢, 易局部复发并转移。主要靠病理诊断, 易与淋巴瘤混淆。发病早期即主张行胸腹部CT检查以确定分期。治疗原则倾向于先作肿物广泛切除, 淋巴结清扫, 尔后放疗。化疗的作用尚不能肯定。局部复发及有远处转移者预后差。本病发生与BC1-2基因及FHIT基因有关, 与P53基因无关。

Abstract: Based upon one case with merker cell carcinoma as verified by operation,light and elec tronmicroscope, immunohistochemistry. The diagnosis, the therapeutic method, pathagenicalfeature and prognosis and molecular biology are disscussed. The literatures are reviewed.Merkel cell carcinoma is a malignant tumor arising from the merkel cell of superficial skin, itbelong to the neuroendocrine tumor. It is rare in the Clinical practice. The head and neck are the most comman site for this carcinoma . It has an obvious tendency of recurrence and metastasis. The diagnosis is made on pathology. It resembles the lymphoma. CT examination should be done at early stage. It is advocated that the tumor should be excised adequately, corresponding lymph node dissection and following radiotherapy should be peroformed.The effect of chemotherapy can not be Proved. The poor prognostic factors are localrecurrence and extensive metastasis. The development of Merkel cell carcinoma is related to Bcl-2 gene and FHIT gene, but us to P⁵³

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参考文献(17)

[1]	Toker C. Trabecular carcinoma of the skin. Arch Derma-tol. 1972, 105:107-110.
[2]	Eftekhari F, Wallace S, Silva EG, et al. Merkel features in 93 cas-es. Br J Radiol, 1996, 69(819):226～233.
[3]	Soltau JB, Smith ME, Custer PL. Merkel cell carcinoma of eyelid. Am J Ophthalmol, 1996, 121(3):331～332.
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[5]	Gollub WJ, Gruen DR, Dershaw DD. Merkel cell carcino-ma:CT finding in 12 patients. AJR Am J Roentgend, 1996, 167(3):617～620.
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[7]	李祥周, 赖仁胜, 乐美兆. 皮肤麦克细胞瘤6例. 中华皮肤病杂志, 1995, 2(28):31～32.
[8]	吕宁, 李竞贤, 刘秀云. 皮肤神经内分泌癌, 中华肿瘤杂志, 1992, 4(6):452～454.
[9]	Miettinen M, Lasdota J. Cutaneous lymphoma-stimulat-ing Merkel cell carcinoma～molecular genetic demeonstra-tion of a clonal disease with divergent immunophenotypes. Mod Pathol, 1995, 8(7):769～774.
[10]	Bassereau G, Manceau A, Soin C, et al. Primary cuta-neous neuroendocrine carcinoma (Merkel cell tumor), clinical and therapeutic update apropos of 4 cases. Ann Otolaryngol Chir Cervicofac, 1995, 112(3):123～128.
[11]	Suntharalingam M, Rudoltz MS, Mendenhall WM, et al. Radiotherapy for Merkel cell carcinoma of the skin of the head and neck. Head Neck, 1995, 17(2):96～101.
[12]	Wynne CJ, Fracr, Kearsley JH, et al. Merkel cell carci-noma:Achemosensitive skin cancer. Cancer, 1988, 62:28～31.
[13]	Pectasides D, Moutzourides G, Dimitriadis M. Chemotherapy for Merkel cell carcinoma with carboplatin and etoposide. Am J Clin Oncol, 1995, 18(5):418～420.
[14]	O'Rourke MGE, Bell JR. Merkel cell tumour with spon-taneous regression. J Dermatol Surg Oncol, 1986, 12:994～997.
[15]	Plettenberg A, Pammer J, Tschachler E. Merkel cells and Merkel cell careinoma express the Bcl～2 proto-oncogene. Exp Dermatol, 1996, 5(2):102～107.
[16]	Sozzi G, Ajder H, Tormielli S. Aberrant FHIT tran-scripts in Merkel cell carcinoma. Cancer Res, 1996, 56(11):2472～2474.
[17]	Rossnick M, Tanssen K, Dockhorn DB. P53 expression in Merkel cell carcinoma of the skin. J Pathol, 1996, 178(suppl):30A.

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Merkel细胞瘤一例报告并文献复习

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