胃肠道神经内分泌癌15例分析  

A clinical analysis on 15 cases with neuroendocrine carcinoma in gastrointestinal tract

作　　者：张小平[1] 尹卫民[2] 

机构地区：[1]江苏大学附属金坛市人民医院消化病科,213200 [2]南京大学附属南京鼓楼医院普通外科

出　　处：《江苏医药》2012年第18期2172-2173,共2页Jiangsu Medical Journal

摘　　要：目的探讨胃肠道神经内分泌癌(NEC)的临床病理特点及诊疗方法。方法回顾分析15例胃肠道NEC患者的临床病理资料。结果本组男9例,女6例。年龄20-76岁。术前仅2例经病理活检确诊,术前临床误诊率为86.7%(13/15)。所有患者均接受手术治疗。免疫组化诊断神经元特异性烯醇化酶(NSE)、嗜铬颗粒蛋白A(CgA)和突触素(Syn)的阳性率分别为86.6%、53.3%和80.0%。本组14例患者得到随访,5年生存率为42.9%。肿瘤浸润超过肌层或有淋巴结转移患者生存时间明显短于浸润浅或无淋巴结转移者[(39.3±7.2)个月vs.(72.4±9.5)个月或(32.6±6.3)个月vs.(72.0±4.4)个月](P<0.01)。结论胃肠道NEC的临床症状、体征均与胃肠道肿瘤相似;确诊需行免疫组化检查;手术治疗效果良好。Objective To investigate the clinicopathologic fetures, diagnosis and treatment of neuroendocrine carcinoma （NEC） in gastrointestinal tract. Methods The clinicopathologic data of fifteen cases with gastrointestinal NEC were retrospectively analyzed. Results Fifteen patients, 9 males and 6 females, were aged from 20 to 76 years old. Only two patients were diagnosed as NEC before operation with a preoperative misdiagnosis rate of 86.7 % （13/15）. All of the patients received surgical treatment. The immunohistochemical analysis of the tumor specimens revealed the characters of NEC,and the positivity rates of NSE,CgA and Syn were 86.6% ,53.3% and 80. 0% ,respectively. The results of follow-up in 14 cases showed that 5-year survival rate was 42.9% and the survival time was shorter in the cases with deep invasion exceeding gastrointestinal muscularis propria or with lymph node metastasis than those with shallow invasion or without lymph node metastasis[（39.3± 7.2） months vs. （72. 4±9. 5） months or （32.6±6.3） months vs. （72. 0524. 4） months] （〈0. 01）. Conclusion Clinical symptoms and signs of gastrointestinal NEC are similar to those of gastrointestinal tumors. A definite diagnosis of NEC depends on pathological examination. The prognosis after surgery is good in the patients with NEC.

关 键 词：神经内分泌癌 胃肠道 

分 类 号：R735[医药卫生—肿瘤]