食管小细胞癌的临床病理、免疫组化及电镜观察  

Clinicopathologic immunohistochemical and ultrastructural observation on small cell carcinomas of the esophagus

作　　者：云径平[1] 林汉良[1] 吴秋良[1] 梁小曼[1] 刘克拉 侯景辉[1] 李锦添[1] 

机构地区：[1]中山医科大学

出　　处：《癌症》1998年第4期251-253,F003,共4页Chinese Journal of Cancer

摘　　要：目的：探讨食管小细胞癌的临床病理特征、抗原表达及超微结构特点。方法：收集食管小细胞癌２８例，分析统计临床病理资料，每例均采用ＳＬＡＢ方法做７项免疫学标记，分别为ＣＫ、ＬＣＡ、Ｓ－１００、ＣＤ５６（神经细胞粘连分子）、ＣＨＡ（铬粒素）、ＮＳＥ（神经特异性烯醇化酶）、ＨＨＦ３５，５例取新鲜组织做电镜观察。结果：患者年龄以中老年多见，部位在中下段，病情发展快，转移早，预后差。大体形态为溃疡型、隆起型，镜下形态可分为燕麦细胞样型和非燕麦细胞样型，免疫组织化学染色：ＣＨＡ及ＣＤ５６阳性率均为９６４％。ＮＳＥ阳性率７５％。ＣＫ、ＬＣＡ、Ｓ－１００及ＨＨＦ－３５均阴性。５例作透射电镜检查，５例瘤细胞胞浆内均可见神经内分泌颗粒，３例可观察到发育不成熟的细胞连接，结论：食管小细胞癌属于高度恶性的神经内分泌肿瘤，ＣＤ５６、ＣＨＡ和ＮＳＥ标记是诊断食管小细胞癌的阳性指标，电镜找到神经内分泌颗粒，对诊断具有确定性意义。?Purpose:Small cell carcinomas (SCC) of the esophagus are rare and its clinicopathological and immunohistochemical and ultrastructurall characteristics were investigated. Methods:28 cases of SCC of the esophagus were detected,aged from 37 to 68 years old,the tumors were located mostly in the middle and lower segment of the esophagus.Results:They showed characteristics such as rapid development,early metastasis and poorer prognosis.Under microscopy,two types of SCC,i.e. oat-type(15/28) and non oat-type (13-28) were divided.Immunohistochemistry showed:CHA was positive in 96.4%,CD56 in 96.4% and NSE in 75%,while staining of CK,LCA,S-100,HHF35 were all negative.Neuroendocrine particles were present in tumor cells in all of 5 cases examined by electric microscopy.Conclusions:SCC of the esophagus is a highly malignant neuroendocrine tumor.These results suggested that CD56,CHA and NSE are useful and sensitive markers and electron microscopic observation may be of confirmative significance in the diagnosis.　　

关 键 词：食管肿瘤 小细胞癌 免疫组织化学 电子显微镜 

分 类 号：R735.102[医药卫生—肿瘤]