胃癌神经内分泌分化的免疫组化及超微结构观察  

Diagnosis value of neuroendocrine differentiation in gastric cancer by immunohistochemistry and electron microscope

作　　者：陈旭东[1] 何松[1] 严桥[2] 潘宏佳[2] 陆晓云[1] 张建兵[1] 周建云[1] 陈莉[2] 张向东[3] 施美娟[3] 

机构地区：[1]南通市肿瘤医院病理科,江苏南通226361 [2]南通大学病理教研室 [3]南通大学附属医院

出　　处：《胃肠病学和肝病学杂志》2007年第5期447-450,共4页Chinese Journal of Gastroenterology and Hepatology

基　　金：江苏省南通市社会发展科技计划资助项目(S30062)

摘　　要：目的观察胃癌神经内分泌(NE)分化的CgA、Syn、NSE免疫组化表达及超微结构形态。方法对168例手术切除石蜡包埋胃癌标本进行CgA、Syn、NSE免疫组化标记,阳性病例分别进行电镜检查。对CgA、Syn、NSE免疫组化在胃癌神经内分泌分化中的诊断价值进行了讨论。结果80例NE标记阳性标本中,电镜下发现NE颗粒39例,检出率为48.8%。Syn+组灵敏度最高,为66.7%;最低的是Syn、CgA、NSE均阳性组,为15.4%。在所有的标记中特异度最高为Syn、CgA、NSE均阳性组,其特异度为97.6%。NSE+组的特异度最低,为24.4%。约登指数排在最前的为CgA+组(0.495),最后的为NSE+组(-0.271)。结论电镜下发现NE颗粒可确定胃癌神经内分泌分化的诊断,免疫组化CgA、Syn阳性可协助诊断。Objective To observe the expression of neuroendocrine（NE） markers such as CgA,Syn and NSE in the popular type of gastric cancer using the immunohistochemistry（IHC） and its ultrastructure morphous under the electron microscope. Methods One hundred and sixty eight specimens were stained with CgA, Syn and NSE antibodies, and positive cases were investigated by electron microscope. Results Eighty cases were NE positive by IHC, and 39 of them were detected with NE granules by electron microscope （48.8%）. The sensitivity of the Syn^＋ group was the highest（66.7% ）. The sensitivity in Syn^＋ ,CgA^＋ and NSE^＋ trible positive group was the lowest（ 15.4% ）. Among all the markers, the specificity of the Syn, CgA and NSE group was the highest （97.6%） , and the lowest one was 24.4% , which was from the NSE^＋ only group. The highest Youden index was from the CgA^＋ group （0. 495） , the lowest of it was from the NSE^＋ group （ - 0. 271 ）. Conclusions The detection of NE granules under the electron microscope is the definite diagnostic criteria for diagnosing the gastric cancer with NE differentiation, using CgA and Syn as the assisting positive markers.

关 键 词：胃癌 神经内分泌 超微结构 免疫组化 

分 类 号：R735.2[医药卫生—肿瘤]