[Clinical analysis of 12 cases of laryngeal neuroendocrine carcinoma].

Objective: To investigate the clinical and pathological features, treatments and prognosis of laryngeal neuroendocrine carcinoma (LNEC). Methods: We conducted the retrospective analysis of the clinical data of 12 patients with LNEC admitted to the Department of Otorhinolaryngology Head and Neck Surgery, Second Hospital of Shanxi Medical University from May 2014 to December 2021, including 9 males and 3 females, aged 50-77 years. There were 4 cases of typical carcinoid tumour (highly differentiated), 5 cases of atypical carcinoid tumour (moderately differentiated) and 3 cases of neuroendocrine small cell carcinoma (hypofractionated). The clinical features, diagnosis, treatment and prognosis of LNEC were analysed. Results: The clinical manifestations of LNEC varied according to the tumour type but did not correlate with the pathological types. The supraglottic type was characterized by sore throat, foreign body sensation in the pharynx, coughing, obstructive sensation when eating and choking on water. The treatments were determined according to the pathological types, lesion location and invasion scope. Of 12 patients 4 underwent horizontal partial laryngectomy plus elective lymphatic dissection plus postoperative radiotherapy/chemotherapy, 4 underwent vertical partial laryngectomy (3 of them with cervical lymphatic dissection), 3 underwent supported laryngoscopic plasma laryngectomy for laryngeal cancer, and 1 abandoned for treatment. With the follow-up of 8 -78 months, 5 patients were alive, 1 died from chemotherapy reactions, 3 died from other diseases, 1 died from lung metastasis, 1 died from lung infection and 1 was lost to follow-up. Conclusion: LNEC is clinically rare, the clinical manifestations are less specificity, diagnosis relies on pathological and immunohistochemical examinations, and treatment modalities and prognoses are closely related to the pathological subtypes of LNEC.目的： 探讨喉神经内分泌癌（laryngeal neuroendocrine carcinoma，LNEC）的临床特点、病理分型、治疗方案和预后。 方法： 回顾性分析2014年5月至2021年12月山西医科大学第二医院耳鼻咽喉头颈外科收治的12例LNEC患者的临床资料，其中男性9例，女性3例，年龄50~77岁。典型类癌（高分化）4例，不典型类癌（中分化）5例，神经内分泌型小细胞癌（低分化）3例。分析LNEC临床特点、诊断、治疗及预后情况。 结果： LNEC临床表现因肿瘤分型而有所不同，与病理分型无相关性，声门上型以咽痛、咽部异物感、咳嗽、进食梗阻感、饮水呛咳表现为主，声门型以声嘶为主要表现。治疗方式根据病理分型、病变位置、侵犯范围决定，4例行水平喉部分切除+择区颈淋巴清扫术+术后放/化疗，4例行垂直喉部分切除术（其中3例行颈淋巴清扫术），3例行支撑喉镜下等离子喉癌切除术，1例放弃治疗。随访时间8~78个月，至随访结束，5例患者健在，1例死于化疗反应，3例死于其他疾病，1例死于肿瘤肺转移，1例死于肺部感染，1例失访。 结论： LNEC临床罕见，临床表现无特异性，确诊需依靠病理学及免疫组化标记，治疗方式及预后情况与喉神经内分泌癌病理亚型密切相关。.