术前胃活检诊断神经内分泌肿瘤类型标准的探讨  

A study on preoperative biopsied diagnosis of types of neuroendocrine tumors of stomach

作　　者：虞积耀[1] 王鲁平[2] 王嘉玲[1] 孟宇红[1] 陆平[1] 胡明[1] 郑集义[1] 姚林[1] 夏敏良[1] Cesare Bordi 

机构地区：[1]海军总医院病理科,北京100037 [2]北京军区总医院病理科 [3]意大利帕马大学

出　　处：《诊断病理学杂志》1997年第4期211-213,共3页Chinese Journal of Diagnostic Pathology

摘　　要：不同类型的胃神经内分泌肿瘤（GNET）其治疗手段不同，因此在手术前对GNET类型的正确诊断十分重要。本文收集52例胃神经内分泌肿瘤，通过对其临床病理特点及患者随访的观察，提出GNET临床病理类型。Ⅰ型胃泌素依赖型类癌：可单发及多发，肿瘤的发生与胃泌素有关，生物学行为多为良性。治疗行息肉切除术或胃窦切除术，预后好。Ⅱ型非胃泌素依赖型类癌：多为散在单发，肿瘤发生与冒犯素无关，肿瘤较Ⅰ型恶性程度高，治疗行胃大部切除术。Ⅲ型胃神经内分泌癌：高度恶性GNET肿瘤，肿瘤低分化，治疗行胃切除术及术后综合化疗，预后差。本文重点对手术前胃内镜诊断GNET不同类型的标准进行了探讨。Fifty two gastric neuroendocrine tumors (GNET) were studied with immunohistochemical methods. It was found that 52 gastric neuroendocrine tumors were divided into three types: Type Ⅰ Gastrin dependent type of canceroid was found in 26 cases associated with chronic atrophic gastritis (CAG), showing tumor extension limited to the mucosa or submucosa, hypergastrinemia and G cell hyerplasia. This type is consistently preceded by and as-sociated with generalize proliferation of endocrine cells in the gastric antral mucosa. Type Ⅱ Non-gastrin dependent type of carcinoid was found in 16 cases. It was not associated with either CAG and never associated with hypergas-trinemia. This type showed more aggressive in character. Type III Neuroendocrine carcinomas were highly aggres-sive tumors. A correct preoperative identification of different types of gastric endocrine tumors has great implica-tion for the treatment and prognosis of the patients.

关 键 词：神经内分泌肿瘤 类型 诊断标准 骨肿瘤 骨活检 

分 类 号：R735.204[医药卫生—肿瘤] R736.04[医药卫生—临床医学]