论文部分内容阅读
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 clinicopathological characteristics and diagnosis and treatment of gastrointestinal neuroendocrine carcinoma (NEC). Methods The clinical and pathological data of 15 patients with gastrointestinal NEC were retrospectively analyzed. Results The group of 9 males and 6 females. Age 20-76 years old. Only 2 cases were confirmed by pathological biopsy before operation, the preoperative clinical misdiagnosis rate was 86.7% (13/15). All patients underwent surgery. The positive rates of neuron specific enolase (NSE), chrome granular protein A (CgA) and synaptophysin (Syn) were 86.6%, 53.3% and 80.0% respectively. The group of 14 patients were followed up, 5-year survival rate was 42.9%. The survival time of tumor infiltrating the muscle layer or lymph node metastasis was significantly shorter than that of infiltrating or without lymph node metastasis [(39.3 ± 7.2) months vs. (72.4 ± 9.5) months or (32.6 ± 6.3) months vs. ( 72.0 ± 4.4) months (P <0.01). Conclusions The clinical symptoms and signs of gastrointestinal NEC are similar to those of gastrointestinal tract. The diagnosis of NEC is required for immunohistochemistry and the surgical treatment is effective.