肿瘤研究与临床
腫瘤研究與臨床
종류연구여림상
CANCER RESEARCH AND CLINIC
2013年
5期
296-299
,共4页
于江媛%林保和%李洁%李囡%王雪鹃%翟士桢%许小宝%张晓鹏%杨志
于江媛%林保和%李潔%李囡%王雪鵑%翟士楨%許小寶%張曉鵬%楊誌
우강원%림보화%리길%리닙%왕설견%적사정%허소보%장효붕%양지
神经内分泌肿瘤%神经元特异性烯醇化酶%免疫组织化学%受体,生长抑素
神經內分泌腫瘤%神經元特異性烯醇化酶%免疫組織化學%受體,生長抑素
신경내분비종류%신경원특이성희순화매%면역조직화학%수체,생장억소
Neuroendocrine neoplasms%Neuronspecific enolase%Immunohistochemistry%Receptor,somatostatin
目的 探讨生物标志物对于胃肠胰神经内分泌肿瘤(GEP-NEN)的诊断价值,以及不同分类GEP-NEN生长抑素受体的表达规律.方法 回顾性分析77例GEP-NEN患者病理学及免疫组织化学表达、血清神经元特异性烯醇化酶(NSE)水平及99Tcm-HYNIC-TOC生长抑素受体显像影像学结果.结果 GEP-NEN突触素(Syn)的阳性表达率为90.4％(66/73),嗜铬粒素A(CgA)的阳性表达率为65.7％(44/67),二者比较差异有统计学意义(x2=12.7,P＜0.01)；70.5％(31/44)的GEP-NEN血清NSE水平升高,在16.02 ～ 5713.00 ng/ml之间；生长抑素受体显像64.9％(50/77)呈阳性结果,且神经内分泌瘤(NET)与神经内分泌癌(NEC)组间阳性率差异有统计学意义(x2=8.23,P＜ 0.01).结论 Syn较CgA有更高的阳性表达,CgA在来源于胃、小肠以及胰腺的GEP-NEN中有着较高的表达；初步证实血清NSE水平可以作为GEP-NEN诊断的辅助指标；生长抑素受体显像阳性率与分化程度相关,分化好的GEP-NEN有着更高的Ⅱ型生长抑素受体表达.
目的 探討生物標誌物對于胃腸胰神經內分泌腫瘤(GEP-NEN)的診斷價值,以及不同分類GEP-NEN生長抑素受體的錶達規律.方法 迴顧性分析77例GEP-NEN患者病理學及免疫組織化學錶達、血清神經元特異性烯醇化酶(NSE)水平及99Tcm-HYNIC-TOC生長抑素受體顯像影像學結果.結果 GEP-NEN突觸素(Syn)的暘性錶達率為90.4％(66/73),嗜鉻粒素A(CgA)的暘性錶達率為65.7％(44/67),二者比較差異有統計學意義(x2=12.7,P＜0.01)；70.5％(31/44)的GEP-NEN血清NSE水平升高,在16.02 ～ 5713.00 ng/ml之間；生長抑素受體顯像64.9％(50/77)呈暘性結果,且神經內分泌瘤(NET)與神經內分泌癌(NEC)組間暘性率差異有統計學意義(x2=8.23,P＜ 0.01).結論 Syn較CgA有更高的暘性錶達,CgA在來源于胃、小腸以及胰腺的GEP-NEN中有著較高的錶達；初步證實血清NSE水平可以作為GEP-NEN診斷的輔助指標；生長抑素受體顯像暘性率與分化程度相關,分化好的GEP-NEN有著更高的Ⅱ型生長抑素受體錶達.
목적 탐토생물표지물대우위장이신경내분비종류(GEP-NEN)적진단개치,이급불동분류GEP-NEN생장억소수체적표체규률.방법 회고성분석77례GEP-NEN환자병이학급면역조직화학표체、혈청신경원특이성희순화매(NSE)수평급99Tcm-HYNIC-TOC생장억소수체현상영상학결과.결과 GEP-NEN돌촉소(Syn)적양성표체솔위90.4％(66/73),기락립소A(CgA)적양성표체솔위65.7％(44/67),이자비교차이유통계학의의(x2=12.7,P＜0.01)；70.5％(31/44)적GEP-NEN혈청NSE수평승고,재16.02 ～ 5713.00 ng/ml지간；생장억소수체현상64.9％(50/77)정양성결과,차신경내분비류(NET)여신경내분비암(NEC)조간양성솔차이유통계학의의(x2=8.23,P＜ 0.01).결론 Syn교CgA유경고적양성표체,CgA재래원우위、소장이급이선적GEP-NEN중유착교고적표체；초보증실혈청NSE수평가이작위GEP-NEN진단적보조지표；생장억소수체현상양성솔여분화정도상관,분화호적GEP-NEN유착경고적Ⅱ형생장억소수체표체.
Objective To assess the value of biomarkers and somatostatin receptor scintigraphy in the diagnosis of gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN).Methods 77 GEP-NEN patients were included.The neuroendocrine properties of the tumors were determined by immunohistochemistry staining of neuroendocrine markers Syn and CgA.Plasma neuronspecific enolase (NSE) levels were measured,and all the patients had 99Tcm-HYNIC-TOC somatostatin receptor scintigraphy results.Results Immunohistochemistry staining positive rates of Syn and CgA were 90.4 ％ (66/73) and 65.7 ％ (44/67),and the former was statistical higher than the latter (X2=12.7,P ＜ 0.01).Plasma NSE levels were significantly higher in GEP-NEN patients (16.02 ng/ml-5713.00 ng/ml).64.9 ％ (50/77) GEP-NEN represented avid uptake in somatostatin receptor scintigraphy.Poorly differentiated GEP-NEN had lower imaging positive rate (x2 =8.23,P ＜ 0.01).Conclusion Immunohistochemistry staining positive rate of Syn is higher than CgA.Origins from stomach,small intestine and pancreas have relatively high CgA expression.Plasma NSE level maybe became another useful marker in the diagnosis of GEP-NEN.Somatostatin receptor scintigraphy results are correlatedwith differentiation.Well differentiated GEP-NEN has higher somatostatin receptor expression.
