摘要
目的探讨食管神经内分泌癌(ENEC)患者的临床表现及病理特点。方法纳入2011年1月至2018年11月郑州大学第一附属医院经病理复诊为ENEC的107例患者,分析其临床表现、肿瘤的部位、肿瘤大小、临床病理分型和免疫组织化学标志物情况。计量资料采用统计描述,分类资料采用卡方检验。结果107例ENEC患者中,首发症状以进食梗噎最常见,占63.6%(68/107);其次为胸背疼痛,占13.1%(14/107)。60.7%(65/107)的患者经内镜活组织检查确诊,39.3%(42/107)的患者经手术病理确诊。肿瘤位于食管胸上段相对较少,占13.1%(14/107);位于胸中段和胸下段分别占45.8%(49/107)和41.1%(44/107)。肿瘤长径为0.7~9.0 cm,中位数为2.5 cm,其中≤2.5 cm者占57.0%(61/107),>2.5 cm者占43.0%(46/107)。107例患者中,溃疡型50例(46.7%),髓质型32例(29.9%),蕈伞型16例(15.0%),隆起型9例(8.4%)。107例患者中,纯神经内分泌癌(P-NEC) 96例(其中小细胞型95例,大细胞型1例),占89.7%;混合性神经内分泌癌(M-NEC)11例(其中小细胞癌鳞状细胞癌混合型9例,小细胞癌腺癌混合型2例),占10.3%。突触素阳性率为99.0%(104/105),CD56阳性率为98.0%(100/102),嗜铬粒蛋白A(CgA)阳性率为31.5%(17/54),Ki-67为>90%~100%占47.7%(51/107)。肿瘤最大径>2.5 cm的P-NEC占42.1(45/107),M-NEC占0.9%(1/107),P-NEC组的肿瘤最大径大于M-NEC组,差异有统计学意义(χ^2=4.311,P=0.038)。结论ENEC是一种临床表现不特异且有高度侵袭性的恶性肿瘤,确诊主要靠组织病理及免疫组织化学检查。
Objective To investigate the clinical and pathological features of patients with esophageal neuroendocrine carcinoma (ENEC). Methods From January 2011 to November 2018, 107 patients with pathologically confirmed ENEC were enrolled at the First Affiliated Hospital of Zhengzhou University. The clinical manifestation, tumor location, tumor size, clinical pathological classification and immunohistochemical markers were analyzed. Statistical description was used for measurement data analysis, and chi-square test was performed for classification data analysis. Results Among 107 patients with ENEC, feeling obstruction during eating was the most common initial symptom, accounting for 63.6%(68/107);followed by chest and back pain, accounting for 13.1%(14/107). About 60.7%(65/107) patients were diagnosed by biopsy under endoscopy and 39.3%(42/107) patients were confirmed by pathological diagnosis after surgery. The proportion of tumor located in the upper thoracic esophagus and middle and lower thoracic segments was 13.1%(14/107), 45.8%(49/107) and 41.1%(44/107), respectively. The length of tumor was 0.7 cm to 9.0 cm, and the median was 2.5 cm. Among them, 57.0%(61/107) were less than 2.5 cm and 43.0%(46/107) were over 2.5 cm. Among 107 patients, 50 (46.7%) patients were ulcerative type, 32 (29.9%) patients were medullary type, 16 (15.0%) patients were mushroom type and nine (8.4%) patients were protrude type. Among 107 patients, 96 (89.7%) patients were pure neuroendocrine carcinoma (P-NEC;including 95 small cell types, one large cell type);11 (10.3%) patients were mixed neuroendocrine carcinoma (M-NEC;including nine small cell carcinoma mixed with squamous cell carcinoma, two small cell carcinoma mixed with adenocarcinoma). The positive rates of synaptophysin, CD56 and chromogranin A were 99.0%(104/105), 98.0%(100/102) and 31.5%(17/54), respectively. Ki-67 proliferation index of 47.7% tumors (51/107) was between 90% and 100%. P-NEC with the maximum diameter over 2.5 cm accounting for 42.1%(45/107), and M-NEC accounting f
作者
孟宇
练延帮
李珊珊
勾贺
王亚梦
陈洁
宋敏
Meng Yu;Lian Yanbang;Li Shanshan;Gou He;Wang Yameng;Chen Jie;Song Min(Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China;Department of Radiology (Imaging and Nuclear Medicine Ward), The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China;Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China;Endoscopy Center, Henan Cancer Hospital, Zhengzhou 450008, China;Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China)
出处
《中华消化杂志》
CAS
CSCD
北大核心
2019年第8期533-538,共6页
Chinese Journal of Digestion
关键词
癌
神经内分泌
食管
免疫组织化学
病理学
临床
Carcinoma, neuroendocrine
Esophagus
Immunohistochemistry
Pathology
Clinic
