原发性肝脏神经内分泌肿瘤17例临床分析  

Clinical analysis of 17 cases of primary hepatic neuroendocrine tumor

作　　者：刘娜[1] 周华邦[1] 胡和平[1] 

机构地区：[1]第二军医大学东方肝胆外科医院肝胆内一科,上海200438

出　　处：《中华消化杂志》2015年第8期534-537,共4页Chinese Journal of Digestion

摘　　要：目的探讨原发性肝脏神经内分泌肿瘤（PHNET）的临床病理特征，提高对该病的认识和诊治水平。方法根据消化系肿瘤WHO分类（2010）神经内分泌肿瘤（NET）分级标准对17例病理诊断明确的PHNET进行分级，并对临床资料进行回顾性分析。组间计数资料比较采用卡方检验。结果对17例PHNET患者的组织标本进行新标准分型，其中5例因标本因素未能进行分类，12例PHNET中NET G1期5例，NETG2期7例，无神经内分泌癌（NEC）病例。17例患者均无明显类癌综合征表现。组织学检查显示，肿瘤细胞呈腺泡状或巢片状排列，可见核分裂象；免疫组织化学染色结果示嗜铬颗粒蛋白阳性5例，突触囊泡蛋白阳性8例，神经特异性烯醇化酶阳性16例。NETG1期患者术后无瘤生存率为80．0％，NET G2期患者术后无瘤生存率为57．1％。结论PHNET确诊主要依靠病理表型及分级，需要在消化系统NET WHO分类的基础上结合肿瘤大小及有无子病灶等多种因素综合判断其恶性程度及预后。Objective To investigate the clinical and pathological characteristics of primary hepatic neuroendocrine tumor （PHNET）, and to improve the understanding, diagnosis and treatment of this disease. Methods Seventeen cases of pathologically diagnosed PHNET had been graded according to 2010 World Health Organization （WHO） neuroendocrine tumor （NET） classification standard, and the clinical data were retrospectively analyzed. χ^2 test was used for count data analysis between groups. Results Seventeen PHNET tissue samples were classified by the new standard. Among them, five cases could not be classified due to unproper specimens. Among the 12 PHNET, five cases of NET were at G1 stage,seven cases at G2 stage, and there was no neuroendocrine carcinoma （NEC）. There was no obvious carcinoid syndrome in all patients. Histological examination showed that the tumor ceils were arranged as acinusor nest flake and with visible nuclear division. The results of immunohistochemical staining indicated that five cases were chromogranin A （CgA） protein positive, eight were synaptophysin （Syn） positive and 16 were neuron-specific enolase （NSE） positive. After operation, the tumor free survive （TFS） rate of NET patients at G1 stage was 80.0%, and that of NET patients at G2 stage was 57.1%. Conclusions PHNET was diagnosed mainly according to pathological phenotype and classification. The degree of malignancy and prognosis was judged on the basis of WHO classification of digestive system neuroendocrine tumors and combined with tumor size, sub-lesions and other factors.

关 键 词：肝肿瘤 肝脏原发性神经内分泌肿瘤 癌 神经内分泌 

分 类 号：R735.7[医药卫生—肿瘤]