消化道内分泌肿瘤49例临床病理分析

目的　探讨一组消化道内分泌肿瘤的临床和病理形态学特点以及分类。方法　复习 4 9例消化道内分泌肿瘤的HE切片 ,用组织芯片技术制片 ,5种抗体做免疫组化染色并观察其结果。结果　 4 9例肿瘤中类癌 4 3例 ,小细胞癌 6例。其中来自前肠 2 7例 ,中肠 10例 ,后肠 12例。免疫组化Syn阳性 34例 (6 9 4 % ) ,CgA阳性 4 5例(91 8% ) ,CD5 6阳性 13例 (2 6 5 % )。阳性率与肿瘤发生部位无相关性。Ki 6 7和p5 3在直径 <1 5cm类癌组无阳性表达。散发型类癌组其得分高低与淋巴结转移与否之间差异不显著。结论　消化道类癌从形态学到生物学行为 1、2型与 3型是完全不同的两组肿瘤 ;CD5 6在小细胞癌组和直径 <1 5cm类癌组有较高的表达率 ;混合型肿瘤占该组肿瘤的 1 3。

Pathological features of neuroendocrine tumor in digestive tract:a clinicopathological analysis of 49 cases

Objective To discuss the clinical and pathologic features as well as classification of the endocrine tumor of gastrointestinal tract. Methods The slides of 49 cases of endocrine tumor in gastrointestinal tract in our department were reviewed.We prepared a tissue array and stained them with the method of hematoxylin|eosin and immunostaining with 5 antibodies. Results There were 43 of carcinoid tumor and 6 cases of small cell carcinoma in this group.The tumors originated from foregut, midgut and hindgut were 27,10 and 12 cases respectively. The immunohistochemical staining showed that Syn,CgA and CD56 were positive in 69.4%, 91.8% and 26.5% respectively.The positive rates had no correlation with the tumor sites.There were no positive expression of p53 and Ki|67 in the group of tumor smaller than 1.5?cm in diameter.Statistical analysis did not show significant difference in scores of Ki|67 and p53 between patients with lymph note metastasis and without in malignant carcinoid tumor. Conclusion There are two types of carcinoid tumor in gastrointestinal tract,which have distinct characteristics in histopathology and biological behavior.CD56 positive expression is higher in the carcinoid tumor of smaller than 1.5?cm in diameter and small cell cancer.The mixed endocrine-exocrine tumor is one-third in the group of tumor.