食管胃交界混合性外分泌-内分泌癌病理形态学观察  

Clinicopathologic diagnosis of mixed exocrine-endocrine carcinoma of the esophagogastric junction

作　　者：王占东[1] 王永军[1] 杨杰[2] 许志宏[3] 王小玲[1] 吴国祥[1] 郭明[1] 

机构地区：[1]河北医科大学第四医院病理科,河北石家庄050011 [2]河北体育学院运动人体科学系,河北石家庄050041 [3]河北省沧州市河间市人民医院外二科,河北河间062450

出　　处：《中国实用外科杂志》2010年第7期581-583,共3页Chinese Journal of Practical Surgery

基　　金：河北省普通高校强势特色学科资助项目编号[冀教高(2005)52];河北省卫生厅2009年医学科学研究重点课题计划(20090512)

摘　　要：目的探讨食管胃交界混合性外分泌-内分泌癌的病理形态学特征。方法 2008年3月河北医科大学第四医院对60例食管胃交界癌利用synaptophysin、chromogranin和neuron-specific enolase(NSE)三种抗体进行免疫组化检测,筛出17例混合性外分泌-内分泌癌,进行病理形态学观察。结果 17例混合性外分泌-内分泌癌可以看到4种不同的组织形态学表现:分化好的腺管状、分化差的低分化腺癌样、印戒细胞样、小细胞癌样。免疫表型:Synaptophysin在17例混合性外分泌-内分泌癌均呈阳性表达,且10例呈弥漫强阳性。10例同时伴有chromogranin表达,11例同时表达NSE,5例同时表达三种抗体。结论食管胃交界混合性外分泌-内分泌癌并不少见,形态学上与印戒细胞癌、管状腺癌、低分化腺癌等存在许多相似之处,非常不易区别,需要依靠免疫组化进行检测,其生物学行为是否与腺癌存在明显差异,需要进一步研究。Objective To investigate the clinieopathological features of mixed exoerine-endocrine carcinoma （MEEC） of the esophagogastrie jam.lion. Methods Seventeen cases of MEEC were distinguished from 60 eases of cancer of the esophagogastrie juntion by S-P immunohistoehemieal staining methods, with synaptophysin,ehromogranin and neuron-specific enolase （NSE） antibodies in March 2008 at Hebei University Fourth Hospital. Results Seventeen cases of MEEC have difterentiated four distinet tumors. The morphological types of the tumors were tublar adenoeareinoma, signet ring cell carcinoma, poor differentiated adenoeareinoma and small cell carcinoma with neuroendoerine diffrentiation. Synaptophysin in 17 eases of mixed exocrine-endoerine carcinoma were positive, and 10 cases showed diffuse strong positive. Ten cases with ehromogranin expression, and 11 cases with NSE expression, 5 cases expressed three antibodies. Conclusion MEEC is a newly described entity, with only very. few cases reported in the literature. More attention should he paid in the daily practice in order to differentiate the tumor from tublar adenocarcinoma, signet ring cell earcinonm and poor differentiated adenocareinoma .The prognosis of the tumor has not determined,which need more studied.

关 键 词：混合性外分泌-内分泌癌 食管胃交界 病理学观察 免疫组织化学染色 

分 类 号：R6[医药卫生—外科学]