胰腺神经内分泌肿瘤72例临床病理特征分析  

Pancreatic neuroendocrine neoplasms:a clinicopathological analysis of 72 cases

作　　者：王林[1] 倪恩德 陈汝福[2] Wang Lin;Ni Ende;Chen Rufu(Department of Pathology,Sun Yat-Sen Memorial Hospital,Sun Yat-Sen University,Guangzhou 510120,China)

机构地区：[1]中山大学孙逸仙纪念医院病理科,广州510120 [2]中山大学孙逸仙纪念医院胆胰外科,广州510120

出　　处：《中华胰腺病杂志》2018年第6期389-392,共4页Chinese Journal of Pancreatology

摘　　要：目的探讨胰腺神经内分泌肿瘤(P-NENs)患者的临床病理学特征及预后情况。方法回顾性分析中山大学孙逸仙纪念医院2011年12月至2017年9月诊断为P-NENs的72例患者的临床病理资料,收集患者的性别、年龄、瘤体大小、局部侵犯、神经浸润及远处转移情况;按2013版中国胃肠胰神经内分泌肿瘤的诊断标准,以组织学核分裂象计数和Ki67增殖指数确定肿瘤的分级。采用免疫组织化学法检测突触素(Syn)、嗜铬粒素A(CgA)、神经元特异性烯醇化酶(NSE)、神经细胞黏附分子(CD56)的表达。结果72例P-NENs患者中男性24例(33.3%),女性48例(66.6%),发病年龄12~76岁,中位发病年龄为56岁;NET G1级24例(33.3%),NET G2级44例(61.1%),NEC G3级4例(5.6%);肿瘤大小0.1~371 cm3,平均(38.2±19.2)cm3;表型标志物Syn、CgA、NSE、CD56阳性率分别为98.6%、95.8%、88.9%、90.3%。肿瘤分级与瘤体大小、局部侵犯、神经浸润、远处(肝)转移均具有相关性(P值均<0.05)。不同分级肿瘤之间的Syn、CgA、NSE及CD56的阳性率差异均无统计学意义。结论肿瘤分级、瘤体大小、局部侵犯、神经浸润、远处(肝)转移是P-NENs重要的临床病理特征及预后评价指标。Syn、CgA、Ki67为诊断P-NENs必要的标志物。Objective To explore the clinicopathological characteristics of pancreatic neuroendocrine neoplasms (P-NENs) and the prognosis.Methods The clinicopathological data of 72 patients with P-NENs in Sun Yat-Sen Memorial Hospital from December 2011 to September 2017 were analyzed retrospectively, and the gender, age, tumor size, local infiltration, neural invasion and distant metastasis were collected. According to the diagnostic criteria of P-NENs (Chinese edition 2013), tumor classification was determined by histological mitotic figure count and cell proliferation index (Ki67) proliferation activity. Expressions of Syn, CgA, NSE and CD56 were determined by immunohistochemical staining.Results Seventy-two patients with P-NENs were enrolled, including 33.3% male(n=24) and 66.6% female (n=48), and the median age was 56 years old (range: 12-76). 24 patients (33.3%) were NET G1, 44 patients (61.1%) were NET G2 and 4 patients (5.6%) were NET G3. The mean size of tumor was 38.2±19.2 cm3 ( range: 0.1-371 cm3). Immunohistochemistry staining positive rates for Syn, CgA, NSE and CD56 were 98.6%, 95.8%, 88.9% and 90.3% respectively. Tumor classification was correlated with tumor size, local infiltration, perineural infiltration and distant (liver) metastasis (all P<0.05). There was no statistically significant differences on positive rate of Syn, CgA, NSE and CD56 among G1, G2 and G3.Conclusions Tumor classification, size, local invasion, perineural infiltration and distant (liver) metastasis were all important clinicopathological features and prognostic factors of P-NENs. Syn, CgA and Ki67 were essential immunohistochemical markers to diagnose P-NENs.

关 键 词：胰腺肿瘤 神经内分泌瘤 免疫组织化学 预后 

分 类 号：R735.9[医药卫生—肿瘤]