阑尾杯状细胞类癌5例临床病理分析  

Goblet cell carcinoid of appendix: a clinicopathological observation of 5 cases

作　　者：郭坚[1] 文国英[1] 张根娣[1] 

机构地区：[1]上海建工医院病理科,上海200083

出　　处：《诊断病理学杂志》2006年第4期250-252,i0002,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的观察阑尾杯状细胞类癌(GCC)的临床病理特征。方法对5例阑尾GCC的组织切片、特殊染色和免疫组化结果进行观察并分析临床资料。结果患者中2例男性,3例女性,平均年龄54.6岁,临床上多表现为急性阑尾炎的症状和体征。巨检:阑尾无明显肿块。镜检:GCC由形态一致的杯状细胞形成巢状结构,呈浸润性生长,5例均侵及阑尾浆膜层,2例侵犯神经。GCC瘤细胞形态上类似于肠腺杯状细胞,无异型性和坏死,缺乏核分裂。瘤细胞AB、PAS、NSE、CgA、Syn、CEA和CK8(+)。随访3例,各为14、156和165个月,均存活,其中2例行右半结肠切除。结论GCC是一种在组织形态和免疫表型上具有外分泌和内分泌肿瘤双重特点的肿瘤,较经典类癌更具侵袭性。患者经阑尾切除+右半结肠切除预后良好。Objective To observe the clinicopathological features of goblet cell carcinoid （GCC） of the appendix. Methods The histological sections, the results of special stains and immunohistochemistry and clinical data were observed and analysed in 5 case, s of GCC. Results The patients were two men and three women with an average age of 54.6 years. Clinically, the majority of the patients presented the signs and symptoms of acute appendicitis. Macroscopically, no masses were found in the appendix. Microscopically, GCC was composed of uniform goblet cells which formed a nest pattern and exhibited an aggressive growthing. The serosal and nerve involvements were observed in 5 cases and 2 cases respectively. The tumor cells were identical to the goblet cell of normal small intestinal crypts morphologically. The atypia, necrosis and mitotic figures of the neoplasm cells were absent. The GCC was positive to AB and PAS stains and expressed NSE, CgA, Syn, CEA, and CK8. Three patients with follow-up had been alive for 14, 156 and 165 months, respectively, and a right hemicolectomy was performed in two of them. Conehtsion GCC has double characteristics of exocrine and endocrine tumors in mrophology and immunotype and has more aggressive behavour than classic carcinoids. The prognosis of the patients with appendectomy and right hemicolectomy is favourable.

关 键 词：类癌 杯状细胞 临床病理学 

分 类 号：R735.36[医药卫生—肿瘤]