摘要
目的观察胃小细胞型神经内分泌癌(SCNEC-G)的临床病理特点,探讨其诊断及鉴别诊断要点,提高其病理诊断准确性,为其综合治疗提供依据。方法对2010年至2015年10例SCNEC-G根治手术标本的组织切片行光镜观察,经免疫组织化学标记,分析突触素(Syn)、嗜铬蛋白A(CgA)、神经细胞黏附分子(CD56)、甲状腺转录因子-1(TTF-1)蛋白和Ki-67的表达情况。结果 SCNEC-G呈浸润性生长,癌细胞呈弥漫、大小不等巢团状、条梭状排列,部分病例局灶可呈假腺样结构,肿瘤表面及肿瘤内部均可见核碎屑和凝固性坏死,癌细胞小,呈圆形、卵圆形、短梭形,核深染,核仁不明显,可见较多核分裂。10例癌组织浸润深度为胃壁深肌层至全层,部分病例浸润至胃壁周围脂肪组织,所有样本均有神经侵犯和脉管内癌栓。10例SCNEC-G患者中,Syn、CgA、CD56、TTF-1、Ki-67阳性至强阳性表达率分别为80.0%、70.0%、80.0%、40.0%和100.0%。结论 SCNEC-G对神经源性抗原敏感性较高,同时部分病例TTF-1阳性表达,在原发灶不明的TTF-1阳性转移性小细胞癌中,仍需考虑SCNEC-G的可能。
Objective To analyze clinical and pathological characteristics of 10 cases of gastric small cell neuroendocrine carcinoma（ SCNEC-G） and to explore the main points of diagnsis and differentiate diagnosis,hoping to improve the accuracy of pathological diagnosis and provide the basis for the comprehensive treatment. Methods From 2010 to 2015,the tissue sections from SCNEC-G specimens of 10 cases underwent radical operation were observed by light microscopy. The tissue sections were labeled by immunohistochemistry and the expression of synaptophysin（ Syn）,chromogranin（ CgA）,neural cell adhesion molecule（ CD56）,thyroid transcription factor-1（ TTF-1） and Ki-67 were analyzed. Results Under light microscope,the tumor cells were arranged irregularly with invasive growth potential. The arrangement of cancer cells was diffuse and different sized nest or spindle-shaped structures. Some of the cases showed focal pseudoglandular pattern. The internal surface of the tumors showed nuclear debris and coagulative necrosis.Cancer cells were small,round,oval,spindle-shaped with hyperchromatic nuclei,nucleoli and morenuclear fission. The invasion of 10 cases of gastric cancer was from deep muscle layer to whole layer. There were infiltrations in peripheral adiposetissue in some cases.All samples had nerve invasion and intravascular cancer embolus. The percentages of 10 SCNEC-G samples with positive to strong positive immunoreactivity were 80. 0%,70. 0%,80. 0%,40. 0% and 100. 0% for Syn,CgA,CD56,TTF-1 and Ki-67,respectively.Conclusion SCNEC-G has a higher sensitivity to neural markers,while part of some cases also express TTF-1. In some metastatic TTF-1 positive small cell carcinoma of unknown primary lesion,we should consider the possibility of SCNEC-G.
出处
《临床肿瘤学杂志》
CAS
2016年第4期357-360,共4页
Chinese Clinical Oncology
