食管胃连接部混合性腺神经内分泌癌1例并文献复习  

Mixed adenoneuroendocrine carcinoma of the esophagogastric junction:A case report and review of the literature

作　　者：袁晓艳[1] 黄颖秋[1] Xiao-Yan Yuan Ying-Qiu Huang(Department of Gastroenterology, General Hospital of Benxi Steel and Iron （Group）, the Fifth Clinical College of China Medical University, Benxi 117000, Liaoning Province, China)

机构地区：[1]中国医科大学第五临床学院本溪钢铁(集团)总医院消化内科,辽宁省本溪市117000

出　　处：《世界华人消化杂志》2017年第29期2660-2664,共5页World Chinese Journal of Digestology

摘　　要：混合性腺神经内分泌癌(mixed adenoneuroendocrine carcinoma,MANEC)同时含有神经内分泌癌(neuroendocrine carcinoma,NEC)和腺癌两种成分,并且每种成分的比例均超过30%.MANEC发病率较低,而发生在食管胃连接部的MANEC临床罕见,迄今仅见3例文献报道.组织学形态是诊断MANEC的基础,但当肿瘤分化较差时,其确诊需要依靠免疫组织化学染色;绝大多数MANEC依靠术后大标本病理诊断.MANEC的组织起源尚不明确,其生物学行为及预后分析存在争议.MANEC目前无特异性治疗,仍以手术治疗为主,辅以综合治疗.本文报道1例以恶性肿瘤椎体转移局部疼痛为首发症状,胃镜下小活检病理确诊的食管胃连接部MANEC.本病例提示:组织学形态是诊断MANEC的基础,但当肿瘤分化较差时,其确诊需要依靠免疫组织化学染色.Mixed adenoneuroendocrine carcinoma（MANEC） simultaneously contains two kinds of carcinoma components, namely, neuroendocrine carcinoma （NEC） and adenocarcinoma, each of which accounts for more than 30% of total carcinoma components. The incidence rate of MANEC cases is relatively lower, and the MANEC cases that occur at the esophagogastric junction are extremely rare, with merely three cases reported in the literature. The histological patterns provide the basis for diagnosis of MANEC. However, in case of poor tumor differentiation, a diagnosis of MANEC depends on immunohistochemical staining. The vast majority of MANEC cases are determined by the postoperative pathologic diagnosis based on large samples. The histological origin of MANEC has not been made clear, and there are disputes over its biological behavior and prognosis. At present, there has been no specific therapy for MANEC, while operative treatment-based comprehensive therapy still plays a dominant role. This case suggests that histological patterns act as the basis for diagnosis of MANEC; However, in case of poor tumor differentiation, the confirmed diagnosis of MANEC relies on immunohistochemical staining.

关 键 词：食管胃连接部 混合性腺神经内分泌癌 组织学 病理学 免疫组织化学 

分 类 号：R735[医药卫生—肿瘤]