乳腺小细胞癌的辅助治疗研究现状

姚玲莉 王金秋 郭宇 叶丹

【摘要】 乳腺小细胞癌是一种形态上低分化的乳腺神经内分泌肿瘤，发病率极低，预后极差。治疗除了手术以外还有辅助治疗。目前针对乳腺小细胞癌临床上暂无标准治疗方案，临床上多参考肺小细胞癌，但效果不佳。辅助治疗方案的选择应依据肿瘤免疫组化，以期达到个体化精准治疗，有效改善患者生存结果。本文复习国内外文献，从内分泌治疗、化学治疗、靶向治疗、免疫治疗等方面介绍乳腺小细胞癌的辅助治疗研究进展。其中，内分泌治疗和细胞毒性藥物治疗在乳腺小细胞癌中应用较广，靶向治疗和免疫治疗有多项相关临床试验，是当前研究热点。

【关键词】 乳腺小细胞癌 乳腺神经内分泌癌 乳腺癌 辅助治疗

Research Status of Adjuvant Therapy for Small Cell Carcinoma of the Breast/YAO Lingli， WANG Jinqiu， GUO Yu， YE Dan. //Medical Innovation of China， 2021， 18（29）： -188

[Abstract] Small cell carcinoma of the breast is a morphologically poorly differentiated neuroendocrine tumor with extremely low morbidity and poor prognosis. Treatments have adjuvant therapies in addition to surgery. However， at present， there is no standard treatment for breast small cell carcinoma， and lung small cell carcinoma is often referred to in clinic， but it doesnt work well. The choice of adjuvant therapy is based on tumor immunohistochemistry in order to achieve individual accurate treatment and effectively improve the survival results of patients. This article reviews the literature at home and abroad and introduces the research progress of adjuvant therapy for breast small cell carcinoma from the aspects of endocrine therapy， chemotherapy， targeted therapy and immunotherapy. Among them， endocrine therapy and chemotherapy are widely used in breast small cell carcinoma， targeted therapy and immunotherapy have a number of related clinical trials， which are the current research hotspots.

[Key words] Small cell carcinoma of breast Neuroendocrine carcinoma of the breast Breast cancer Adjuvant therapy

First-authors address： School of Medicine， Ningbo University， Ningbo 315211， China

doi：10.3969/j.issn.1674-4985.2021.29.046

乳腺神经内分泌肿瘤被视为一种上皮起源的独立的实体乳腺癌，并以形态学分类，低分化神经内分泌癌为小细胞癌[1]。95%原发小细胞癌常发生在肺部，原发乳腺小细胞癌（small cell carcimoma of breast，SCCB）发生率极低，占原发性乳腺癌不足1%。但SCCB是一种高度恶性的肿瘤，发现时相对晚期，42%的乳腺小细胞癌患者表现为局限性疾病，39%的患者表现为局部疾病，19%的患者表现为远处转移。一项关于乳腺小细胞癌的大型SEER数据库研究显示，与乳腺神经内分泌肿瘤相比，它的疾病特异性生存期（disease-specific survival，DSS）和总生存期（overall survival，OS）更短，5年DSS率为50.5%，5年OS率为32%[2]。介于病例数较少，目前缺乏大型前瞻性研究与针对性临床治疗指南，临床上以肺小细胞癌辅助治疗方案为参考，常难达到预期效果，亟须进一步提高对它的认识与总结。……