中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2015年
8期
534-537
,共4页
肝肿瘤%肝脏原发性神经内分泌肿瘤%癌 ,神经内分泌
肝腫瘤%肝髒原髮性神經內分泌腫瘤%癌 ,神經內分泌
간종류%간장원발성신경내분비종류%암 ,신경내분비
Liver neoplasms%Primary hepatic neuroendocrine tumor%Carcinoma,neuroendocrine
目的：探讨原发性肝脏神经内分泌肿瘤（PHNET ）的临床病理特征，提高对该病的认识和诊治水平。方法根据消化系肿瘤 WHO 分类（2010）神经内分泌肿瘤（NET ）分级标准对17例病理诊断明确的 PHNET 进行分级，并对临床资料进行回顾性分析。组间计数资料比较采用卡方检验。结果对17例 PHNET 患者的组织标本进行新标准分型，其中5例因标本因素未能进行分类，12例PHNET中 NET G1期5例，NET G2期7例，无神经内分泌癌（NEC）病例。17例患者均无明显类癌综合征表现。组织学检查显示，肿瘤细胞呈腺泡状或巢片状排列，可见核分裂象；免疫组织化学染色结果示嗜铬颗粒蛋白阳性5例，突触囊泡蛋白阳性8例，神经特异性烯醇化酶阳性16例。 NET G1期患者术后无瘤生存率为80．0％，NET G2期患者术后无瘤生存率为57．1％。结论 PHNET 确诊主要依靠病理表型及分级，需要在消化系统 NET WHO 分类的基础上结合肿瘤大小及有无子病灶等多种因素综合判断其恶性程度及预后。
目的：探討原髮性肝髒神經內分泌腫瘤（PHNET ）的臨床病理特徵，提高對該病的認識和診治水平。方法根據消化繫腫瘤 WHO 分類（2010）神經內分泌腫瘤（NET ）分級標準對17例病理診斷明確的 PHNET 進行分級，併對臨床資料進行迴顧性分析。組間計數資料比較採用卡方檢驗。結果對17例 PHNET 患者的組織標本進行新標準分型，其中5例因標本因素未能進行分類，12例PHNET中 NET G1期5例，NET G2期7例，無神經內分泌癌（NEC）病例。17例患者均無明顯類癌綜閤徵錶現。組織學檢查顯示，腫瘤細胞呈腺泡狀或巢片狀排列，可見覈分裂象；免疫組織化學染色結果示嗜鉻顆粒蛋白暘性5例，突觸囊泡蛋白暘性8例，神經特異性烯醇化酶暘性16例。 NET G1期患者術後無瘤生存率為80．0％，NET G2期患者術後無瘤生存率為57．1％。結論 PHNET 確診主要依靠病理錶型及分級，需要在消化繫統 NET WHO 分類的基礎上結閤腫瘤大小及有無子病竈等多種因素綜閤判斷其噁性程度及預後。
목적：탐토원발성간장신경내분비종류（PHNET ）적림상병리특정，제고대해병적인식화진치수평。방법근거소화계종류 WHO 분류（2010）신경내분비종류（NET ）분급표준대17례병리진단명학적 PHNET 진행분급，병대림상자료진행회고성분석。조간계수자료비교채용잡방검험。결과대17례 PHNET 환자적조직표본진행신표준분형，기중5례인표본인소미능진행분류，12례PHNET중 NET G1기5례，NET G2기7례，무신경내분비암（NEC）병례。17례환자균무명현유암종합정표현。조직학검사현시，종류세포정선포상혹소편상배렬，가견핵분렬상；면역조직화학염색결과시기락과립단백양성5례，돌촉낭포단백양성8례，신경특이성희순화매양성16례。 NET G1기환자술후무류생존솔위80．0％，NET G2기환자술후무류생존솔위57．1％。결론 PHNET 학진주요의고병리표형급분급，수요재소화계통 NET WHO 분류적기출상결합종류대소급유무자병조등다충인소종합판단기악성정도급예후。
Objective To investigate the clinical and pathological characteristics of primary hepatic neuroendocrine tumor (PHNET ) ,and to improve the understanding ,diagnosis and treatment of this disease .Methods Seventeen cases of pathologically diagnosed PHNET had been graded according to 2010 World Health Organization (WHO) neuroendocrine tumor (NET ) classification standard ,and the clinical data were retrospectively analyzed . χ2 test was used for count data analysis between groups . Results Seventeen PHNET tissue samples were classified by the new standard .Among them ,five cases could not be classified due to unproper specimens .Among the 12 PHNET ,five cases of NET were at G1 stage , seven cases at G2 stage ,and there was no neuroendocrine carcinoma (NEC ) . There was no obvious carcinoid syndrome in all patients .Histological examination showed that the tumor cells were arranged as acinusor nest flake and with visible nuclear division .The results of immunohistochemical staining indicated that five cases were chromogranin A (CgA) protein positive ,eight were synaptophysin (Syn) positive and 16 were neuron‐specific enolase (NSE) positive .After operation ,the tumor free survive (TFS ) rate of NET patients at G1 stage was 80 .0% ,and that of NET patients at G2 stage was 57 .1% .Conclusions PHNET was diagnosed mainly according to pathological phenotype and classification . The degree of malignancy and prognosis was judged on the basis of WHO classification of digestive system neuroendocrine tumors and combined with tumor size ,sub‐lesions and other factors .
