- 单一三级医疗中心 2009–2025 年 18–50 岁 Merkel 细胞癌（MCC）共 13 例，中位年龄 40 岁，女性 61.5%；有资料的 11 例中 36.4% 存在既往免疫抑制。
- 部位以四肢最多（46.2%）；结节状生长 63.6%、浸润性 27.3%；中位 Breslow 厚度 10.5 mm，中位核分裂 46/mm²；Merkel 细胞多瘤病毒（大 T 抗原 CISH/IHC）阳性 62.5%（5/8）。
- 就诊时淋巴结转移 60.0%，远处转移 54.5%；2 年、5 年总生存 74.1%、59.3%——年轻并不意味着惰性，免疫抑制比例高。
收录范围：PubMed 英文摘要及中文翻译（abstract-only）。原文为订阅制（Ovid/LWW 页面无开放全文），未采集全文、图表。
摘要
Merkel 细胞癌（MCC）是一种罕见、侵袭性的皮肤神经内分泌癌，主要累及老年人。发生于年轻患者的 MCC 极为罕见，其临床病理特征仍描述甚少。我们回顾性复查了 2009 年至 2025 年间在一家三级医疗中心确诊 MCC、年龄 18 至 50 岁患者的临床记录、组织病理学及结局。共识别出 13 例患者，中位年龄 40 岁（范围：18 至 50 岁）；61.5% 为女性。在 11 例有可用资料的患者中，36.4% 存在既往免疫抑制。肿瘤最常发生于四肢（46.2%），其次为头颈部（23.1%）、躯干（15.4%）及原发灶不明（15.4%）。最常见的生长方式为结节状（63.6%），其次为浸润性（27.3%）。中位 Breslow 厚度为 10.5 mm，中位核分裂率为 46/mm²。所有病例的免疫组化染色均符合 MCC。在可评估病例中，62.5%（5/8）经大 T 抗原显色原位杂交和/或免疫组化检出 Merkel 细胞多瘤病毒。60.0% 的患者就诊时已有淋巴结转移，54.5% 发生远处转移。Kaplan-Meier 估计的总生存率 2 年为 74.1%，5 年为 59.3%。在这一单中心队列中，早发性 MCC 与较高的免疫抑制比例以及相当程度的区域与远处转移负担相关，凸显了其与以老年人为主的既往 MCC 人群在临床病理上的差异。
- Single tertiary-centre series of 13 patients aged 18–50 with Merkel cell carcinoma (MCC), 2009–2025; median age 40, 61.5% female; 36.4% of 11 with data had pre-existing immune suppression.
- Extremities were the commonest site (46.2%); nodular growth 63.6%, infiltrative 27.3%; median Breslow depth 10.5 mm and median mitotic rate 46/mm²; Merkel cell polyomavirus (large T antigen CISH/IHC) detected in 62.5% (5/8).
- Nodal metastases at presentation in 60.0% and distant metastases in 54.5%; 2- and 5-year overall survival 74.1% and 59.3%.
Scope: PubMed abstract only. The article is subscription-only (no open full text on the Ovid/LWW page), so full text, figures and tables were not collected.
Abstract
Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous neuroendocrine carcinoma that predominantly affects older adults. MCC arising in younger patients is exceedingly rare, and its clinicopathologic features remain poorly described. We retrospectively reviewed clinical records, histopathology, and outcomes of patients aged 18 to 50 years diagnosed with MCC at a single tertiary care center between 2009 and 2025. A total of 13 patients were identified with a median age of 40 years (range: 18 to 50 y); 61.5% were female. Of 11 patients with available data, 36.4% had pre-existing immune suppression. Tumors arose most commonly on the extremities (46.2%), followed by the head and neck (23.1%), trunk (15.4%), and unknown primary (15.4%). The most common growth pattern was nodular (63.6%), followed by infiltrative (27.3%). Median Breslow depth was 10.5 mm and median mitotic rate was 46/mm². Immunohistochemical staining was consistent with MCC in all cases. Merkel cell polyomavirus was detected by large T antigen chromogenic in situ hybridization and/or immunohistochemistry in 62.5% of assessable cases (5/8). Lymph node metastases were present at presentation in 60.0% of patients, and distant metastases developed in 54.5%. Kaplan-Meier estimated overall survival was 74.1% at 2 years and 59.3% at 5 years. In this single-institution cohort, early-onset MCC was associated with elevated rates of immune suppression and a substantial burden of regional and distant metastatic disease, highlighting clinicopathologic distinctions from predominantly older historical MCC populations.