CAJ | 학술논문

目的分析原发性浅表食管小细胞神经内分泌癌的临床病理学及免疫组织化学特征,以寻找浅表食管小细胞神经内分泌癌合适的诊断标志物及治疗方法.方法回顾性分析15例原发性浅表食管小细胞神经内分泌癌的临床病理学特征,并采用免疫组织化学MaxVision方法检测嗜铬粒素A(CgA)、神经元特异性烯醇化酶(NSE)、突触素、CD56、甲状腺转录因子-1(TTF-1)、细胞角蛋白AE1/AE3、CK34βE12及CK10/13在食管小细胞神经内分泌癌中的表达.结果原发性浅表食管小细胞神经内分泌癌的发病率占同期浅表食管癌的4.8％(15/312).患者中位生存时间19个月,平均生存时间23.7个月.1、2和5年生存的分别有10、5和1例.免疫组织化学标志物NSE、突触素、AE1/AE3均为阳性,CD56阳性14例,TTF-1阳性9例,CgA阳性8例,CK34βE12阳性1例,CK10/13均为阴性.结论原发性浅表食管小细胞神经内分泌癌恶性度高,进展快速,预后很差.建立在放化疗联合外科切除基础上的系统性治疗或许有助于延长患者的生存期.NSE、突触素、AE1/AE3、CD56、TTF-1、CgA在食管小细胞神经内分泌癌中的高表达对其诊断及鉴别诊断具有一定应用价值.
목적 분석원발성천표식관소세포신경내분비암적림상병이학급면역조직화학특정,이심조천표식관소세포신경내분비암합괄적진단표지물급치료방법.방법 회고성분석15례원발성천표식관소세포신경내분비암적림상병이학특정,병채용면역조직화학MaxVision방법검측기락립소A(CgA)、신경원특이성희순화매(NSE)、돌촉소、CD56、갑상선전록인자-1(TTF-1)、세포각단백AE1/AE3、CK34βE12급CK10/13재식관소세포신경내분비암중적표체.결과 원발성천표식관소세포신경내분비암적발병솔점동기천표식관암적4.8％(15/312).환자중위생존시간19개월,평균생존시간23.7개월.1、2화5년생존적분별유10、5화1례.면역조직화학표지물NSE、돌촉소、AE1/AE3균위양성,CD56양성14례,TTF-1양성9례,CgA양성8례,CK34βE12양성1례,CK10/13균위음성.결론 원발성천표식관소세포신경내분비암악성도고,진전쾌속,예후흔차.건립재방화료연합외과절제기출상적계통성치료혹허유조우연장환자적생존기.NSE、돌촉소、AE1/AE3、CD56、TTF-1、CgA재식관소세포신경내분비암중적고표체대기진단급감별진단구유일정응용개치.
Objective To study the clinicopathologic and immunohistochemical features of primary superficial esophageal small cell neuroendocrine carcinoma (ESCNC).Methods The clinical,pathologic and immunohistochemical features were retrospectively analyzed in 15 cases of superficial ESCNC.An immunohistochemical study for chromogranin A,neuron-specific enolase,synaptophysin,CD56,TTF-1,34βE12,AE1/AE3,and CK10/13 was performed.Results Superficial ESCNC accounted for 4.8％ ( 15/312) of all cases of superficial carcinoma of the esophagus encountered during the same period.The median survival time was 19 months and the mean survival time was 23.7 months after diagnosis.The one,two and five-year survival rates were 10/15,5/15 and 1/15,respectively.The immunophenotypic profile was as follows:neuron-specific enolase ( 15/15 ),synaptophysin ( 15/15 ),AE1/AE3 ( 15/15 ),CD56 ( 14/15),TTF-1 (9/15),chromogranin A ( 8/15 ),34βE12 ( 1/15 ) and CK10/13 (0/15).Conclusions Superficial ESCNC is a rare and aggressive malignant tumor with poor prognosis.Surgical resection coupled with post-operative chemoradiotherapy is the mainstay of treatment.The immunohistochemical study is valuable in pathologic diagnosis and differential diagnosis.