胃癌伴神经内分泌分化临床诊治及预后分析

目的比较两组伴或不伴神经内分泌细胞分化（neuroendocrinecelldifferentiation，NED）胃癌患者的临床病理特征和预后差异。方法对174例胃癌资料进行回顾性分析，免疫组化检测神经内分泌标记物嗜铬素（CgA）、突触素fSyn）、神经元烯醇化酶（NSE）在肿瘤组织中的表达。结果174例中37例表现为伴神经内分泌细胞分化（21．3％）。肿瘤发生部位、浸润深度、远处转移、TNM分期与胃癌是否伴有神经内分泌细胞分化具有明显相关性。伴NED的胃癌患者1年生存率43％、3年生存率23％明显低于不伴NED的1年生存率58％、3年生存率44％，χ2=4．359，P=0．037。结论胃癌伴NED患者较不伴NED的患者术后生存时间短，预后较差。胃癌伴NED可能是预后不良的重要因素之一。

Clinical diagnosis and treatment of gastric cancer accompanying neuroendocrine cell differentiation and its prognosis

Objective To compare the clinical and pathological characteristics of gastric cancer patients accompanying or not accompanying neuroendocrine cell differentiation （NED） and their prognosis. Methods Clinical data about 174 gastric cancer patients were retrospectively analyzed. Expression of neuroendocrine markers, CgA, Syn and NSE, in gastric cancer tissue was detected by immunohistochemistry. Results Of the 174 gastric cancer patients, 37（21.3%） were diagnosed with NED. Tumor location, infiltration depth, TNM stage and distant metastasis were significantly related with NED. The 1- and 3- year survival rates were significantly lower in gastric cancer patients accompanying NED than in those not accompanying NED （43% vs 58%, 23% vs 44%, χ2=4.359, P=0.037）. Conclusion The survival time is shorter and the prognosis is poorer in gastric cancer patients accompanying NED than in those not accompanying NED after important factors for the poor prognosis of gastric cancer patients. operation. Gastric cancer accompanying NED may be one of the