消化系统神经内分泌肿瘤77例免疫组织化学、神经元特异性烯醇化酶水平及生长抑素受体显像结果分析  

Analysis of immunohistochemistry staining, neuronspecific enolase level and somatostatin receptor scintigraphy of 77 cases with digestive neuroendocrine neoplasm

作　　者：于江媛[1] 林保和[1] 李洁[1] 李囡[1] 王雪鹃[1] 翟士桢[1] 许小宝[1] 张晓鹏[1] 杨志[1] 

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所核医学科恶性肿瘤发病机制及转化研究教育部重点实验室, 100142

出　　处：《肿瘤研究与临床》2013年第5期296-299,共4页Cancer Research and Clinic

摘　　要：目的 探讨生物标志物对于胃肠胰神经内分泌肿瘤（GEP-NEN）的诊断价值,以及不同分类GEP-NEN生长抑素受体的表达规律.方法 回顾性分析77例GEP-NEN患者病理学及免疫组织化学表达、血清神经元特异性烯醇化酶（NSE）水平及99Tcm-HYNIC-TOC生长抑素受体显像影像学结果.结果 GEP-NEN突触素（Syn）的阳性表达率为90.4％（66/73）,嗜铬粒素A（CgA）的阳性表达率为65.7％（44/67）,二者比较差异有统计学意义（x2=12.7,P＜0.01）；70.5％（31/44）的GEP-NEN血清NSE水平升高,在16.02 ～ 5713.00 ng/ml之间；生长抑素受体显像64.9％（50/77）呈阳性结果,且神经内分泌瘤（NET）与神经内分泌癌（NEC）组间阳性率差异有统计学意义（x2=8.23,P＜ 0.01）.结论 Syn较CgA有更高的阳性表达,CgA在来源于胃、小肠以及胰腺的GEP-NEN中有着较高的表达；初步证实血清NSE水平可以作为GEP-NEN诊断的辅助指标；生长抑素受体显像阳性率与分化程度相关,分化好的GEP-NEN有着更高的Ⅱ型生长抑素受体表达.Objective To assess the value of biomarkers and somatostatin receptor scintigraphy in the diagnosis of gastroenteropancreatic neuroendocrine neoplasm （GEP-NEN）.Methods 77 GEP-NEN patients were included.The neuroendocrine properties of the tumors were determined by immunohistochemistry staining of neuroendocrine markers Syn and CgA.Plasma neuronspecific enolase （NSE） levels were measured,and all the patients had 99Tcm-HYNIC-TOC somatostatin receptor scintigraphy results.Results Immunohistochemistry staining positive rates of Syn and CgA were 90.4 % （66/73） and 65.7 % （44/67）,and the former was statistical higher than the latter （X2=12.7,P 〈 0.01）.Plasma NSE levels were significantly higher in GEP-NEN patients （16.02 ng/ml-5713.00 ng/ml）.64.9 % （50/77） GEP-NEN represented avid uptake in somatostatin receptor scintigraphy.Poorly differentiated GEP-NEN had lower imaging positive rate （x2 =8.23,P 〈 0.01）.Conclusion Immunohistochemistry staining positive rate of Syn is higher than CgA.Origins from stomach,small intestine and pancreas have relatively high CgA expression.Plasma NSE level maybe became another useful marker in the diagnosis of GEP-NEN.Somatostatin receptor scintigraphy results are correlatedwith differentiation.Well differentiated GEP-NEN has higher somatostatin receptor expression.

关 键 词：神经内分泌肿瘤 神经元特异性烯醇化酶 免疫组织化学 受体 生长抑素 

分 类 号：R735[医药卫生—肿瘤]