中华肿瘤杂志
中華腫瘤雜誌
중화종류잡지
CHINESE JOURNAL OF ONCOLOGY
2014年
7期
522-527
,共6页
胃肿瘤%神经内分泌瘤%癌,神经内分泌%嗜铬素A%病理学
胃腫瘤%神經內分泌瘤%癌,神經內分泌%嗜鉻素A%病理學
위종류%신경내분비류%암,신경내분비%기락소A%병이학
Stomach neoplasms%Neuroendocrine tumors%Carcinoma,neuroendocrine%Chromogranin A%Pathology
目的 分析原发于胃(含贲门)不同类型神经内分泌肿瘤的临床病理特征.方法 回顾性分析75例原发于胃(含贲门)神经内分泌肿瘤的发生部位、组织学类型、浸润深度和转移情况等临床病理资料,采用SP法检测生长抑素、突触素、嗜铬素A、CD56、S-100、神经元特异性烯醇化酶和CD57的表达情况.结果 胃神经内分泌肿瘤的发生率占同期胃癌的1.5％,其中神经内分泌瘤G1级、G2级、G3级和混合性腺神经内分泌癌(MANEC)所占比例分别为16.0％(12/75)、1.3％ (1/75)、53.3％ (40/75)和29.3％ (22/75).神经内分泌瘤G1级患者中,41.7％(5/12)为多灶性病变,并伴有周围胃黏膜的神经内分泌细胞增生.54.7％ (41/75)的神经内分泌肿瘤发生在贲门.神经内分泌瘤G1级、MANEC和G3级的术前活检与术后病理诊断的符合率分别为75.0％ (9/12)、72.7％ (16/22)和25.0％(10/40),1例G2级患者术前活检与术后病理诊断不符.结论 胃神经内分泌肿瘤主要发生在贲门,恶性度较高.胃神经内分泌肿瘤活检与手术病理诊断的符合率低,术前活检诊断困难.
目的 分析原髮于胃(含賁門)不同類型神經內分泌腫瘤的臨床病理特徵.方法 迴顧性分析75例原髮于胃(含賁門)神經內分泌腫瘤的髮生部位、組織學類型、浸潤深度和轉移情況等臨床病理資料,採用SP法檢測生長抑素、突觸素、嗜鉻素A、CD56、S-100、神經元特異性烯醇化酶和CD57的錶達情況.結果 胃神經內分泌腫瘤的髮生率佔同期胃癌的1.5％,其中神經內分泌瘤G1級、G2級、G3級和混閤性腺神經內分泌癌(MANEC)所佔比例分彆為16.0％(12/75)、1.3％ (1/75)、53.3％ (40/75)和29.3％ (22/75).神經內分泌瘤G1級患者中,41.7％(5/12)為多竈性病變,併伴有週圍胃黏膜的神經內分泌細胞增生.54.7％ (41/75)的神經內分泌腫瘤髮生在賁門.神經內分泌瘤G1級、MANEC和G3級的術前活檢與術後病理診斷的符閤率分彆為75.0％ (9/12)、72.7％ (16/22)和25.0％(10/40),1例G2級患者術前活檢與術後病理診斷不符.結論 胃神經內分泌腫瘤主要髮生在賁門,噁性度較高.胃神經內分泌腫瘤活檢與手術病理診斷的符閤率低,術前活檢診斷睏難.
목적 분석원발우위(함분문)불동류형신경내분비종류적림상병리특정.방법 회고성분석75례원발우위(함분문)신경내분비종류적발생부위、조직학류형、침윤심도화전이정황등림상병리자료,채용SP법검측생장억소、돌촉소、기락소A、CD56、S-100、신경원특이성희순화매화CD57적표체정황.결과 위신경내분비종류적발생솔점동기위암적1.5％,기중신경내분비류G1급、G2급、G3급화혼합성선신경내분비암(MANEC)소점비례분별위16.0％(12/75)、1.3％ (1/75)、53.3％ (40/75)화29.3％ (22/75).신경내분비류G1급환자중,41.7％(5/12)위다조성병변,병반유주위위점막적신경내분비세포증생.54.7％ (41/75)적신경내분비종류발생재분문.신경내분비류G1급、MANEC화G3급적술전활검여술후병리진단적부합솔분별위75.0％ (9/12)、72.7％ (16/22)화25.0％(10/40),1례G2급환자술전활검여술후병리진단불부.결론 위신경내분비종류주요발생재분문,악성도교고.위신경내분비종류활검여수술병리진단적부합솔저,술전활검진단곤난.
Objective The aim of this study was to investigate the clinicopathological features of different histological types of primary gastric neuroendocrine neoplasms (including the esophagogastric junction),and to analyze the characteristics and difficulties in diagnosis of all the subtypes of this disease.Methods 75 cases of primary gastric neuroendocrine neoplasms (including the esophagogastric junction) were included in this study.The expressions of several markers including somatostatin,synaptophysin,chromogranin A,CD56,S-100,neuron-specific enolase and CD57 were assayed in all the specimens by immunohistochemical staining,and their significance in the diagnosis and prognosis of gastric neuroendocrine neoplasms were assessed.In addition,the relationship between various clinical parameters such as tumor location,histological types,depth of invasion and metastasis was also analyzed.Results The incidence of gastric neuroendocrine neoplasms accounted for 1.5％ of gastric cancer in the same period,and the proportion of each subtype was 53.3％ (40/75) in G3,29.3％ (22/75) in MANEC,16.0％ in G1 (12/75),and 1.3％ (1/75) in G2,respectively.41.7％ (5/12) of the G1 showed multifocal lesions,accompanyied with neuroendocrine cell hyperplasia in the gastric mucosa.54.67％ (41/75) of the NEN located in the esophagogastric junction.The lymph node metastasis of MANEC is unique.The coincidence rate in diagnosis of preoperative biopsies and postoperative specimen was 75.0％ (9/12) in G1,72.7％ (16/22) in MANEC,and 25.0％ (10/40) in G3,respectively.Conclusions Gastric neuroendocrine neoplasms occur mainly in the esophagogastric junction,and most of them were highly malignant.The coincidence rate of preoperative and postoperative pathological diagnosis for primary gastric neuroendocrine neoplasms is low.Therefore,it should be very cautious when diagnosis of this disease is made in a preoperative biopsy.
