CAJ | 학술논문

目的：研究胰腺神经内分泌肿瘤的临床病理特征及预后。方法收集12例胰腺神经内分泌肿瘤的临床病例资料，根据WHO（2010）消化系统胰腺神经内分泌肿瘤的分级标准进行形态分析，同时讨论其临床病理特征与肿瘤恶性程度、生物行为及临床预后的关系。结果12例中7例男性，5例女性，平均年龄45.2岁，其中功能型肿瘤4例，表现为相应的激素分泌症状。无功能型8例，多无症状或表现为腹痛，腹胀及背痛就诊，肿瘤最大径0.8～16 cm，平均直径4.2 cm，肿瘤主要由小圆形细胞构成，细胞排列成巢团状，腺样，实性，间质促纤维反应明显。免疫组化示CgA和Syn多呈弥漫（+），广谱CK和E-cadherin （+），vimentin、CD10和β-catenim（核）等标记物则多为（－）。组织学分级：6例为G1，4例为G2，2例为G3，随访3～20个月，死亡4例，其中G2，2例，G3，2例。结论胰腺内分泌肿瘤（PNEN）是一组恶性的异质性少见肿瘤，从惰性的临床进程到高度侵袭性的生物学行为均可见到，不同组织学分型的PNEN临床病理特点各不相同，因此提高PNEN的确诊率对规范化的综合治疗具有重要作用。
목적：연구이선신경내분비종류적림상병리특정급예후。방법수집12례이선신경내분비종류적림상병례자료，근거WHO（2010）소화계통이선신경내분비종류적분급표준진행형태분석，동시토론기림상병리특정여종류악성정도、생물행위급림상예후적관계。결과12례중7례남성，5례녀성，평균년령45.2세，기중공능형종류4례，표현위상응적격소분비증상。무공능형8례，다무증상혹표현위복통，복창급배통취진，종류최대경0.8～16 cm，평균직경4.2 cm，종류주요유소원형세포구성，세포배렬성소단상，선양，실성，간질촉섬유반응명현。면역조화시CgA화Syn다정미만（+），엄보CK화E-cadherin （+），vimentin、CD10화β-catenim（핵）등표기물칙다위（－）。조직학분급：6례위G1，4례위G2，2례위G3，수방3～20개월，사망4례，기중G2，2례，G3，2례。결론이선내분비종류（PNEN）시일조악성적이질성소견종류，종타성적림상진정도고도침습성적생물학행위균가견도，불동조직학분형적PNEN림상병리특점각불상동，인차제고PNEN적학진솔대규범화적종합치료구유중요작용。
Objective Analyse the clinical pathological characteristics and prognosis of pancreatic neuroendocrine tumor. Methods Collected data of 12 cases of pancreatic neuroendocrine tumor, conducted morphological analysis according to the WHO (2010) of the digestive system classiifcation standard of pancreatic neuroendocrine tumor, and discuss its clinical pathological features and tumor malignant degree, biological behavior and the relationship between the clinical prognosis. Results In the 12 cases, 7 cases were male, 5 cases were female, average age was 45.2 years old, including 4 cases of functional tumor showed symptoms of the corresponding hormone secretion. No function type in 8 cases, most of which were without symptoms or mainly abdominal pain and abdominal distension. The maximum diameter of the tumorranged were 0.8 to 16 cm, the average diameter was 4.2 cm, the tumor was mainly composed of small round cells, cells arranged in nests, adenoid, solid, stromal desmoplastic stroma significantly. Immunohistochemica l staining showed that CgA and Syn diffuse(+), a broad spectrum CK and E-cadherin (+), vimentin, CD10 and β-catenim (nuclear) and other mark ers for (-). Histological grade:6 cases were G1, 4 cases were G2, 2 cases were G3. Followed up for 3~20 months, 4 cases died, in which 2 cases were G2, 2 cases were G3. Conclusion Pancreatic endocrine tumors (PNEN) is a group of heterogeneous malignant tumor, increase the positive rate of PNEN plays an important role in the standardized comprehensive treatment. .