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目的:分析乳腺神经内分泌癌的病理特征及预后情况。方法回顾性分析山西省肿瘤医院2008年1月至2013年7月收治的7例乳腺神经内分泌癌患者的病理特征、临床特点、治疗及预后。结果7例乳腺神经内分泌癌患者均为女性,年龄41~60岁,平均年龄52.3岁,均以无痛性乳腺肿物就诊。患者病理特征具有神经内分泌癌的形态学特点,免疫组织化学染色结果突触素阳性6例,抗神经特异性烯醇化酶阳性6例,嗜铬素A阳性5例,雌激素受体阳性6例,孕激素受体阳性6例,CerbB-2阳性1例,p53阳性1例。术后随访9~24个月(平均15.6个月),患者均无瘤生存,无复发及远处转移。结论该7例乳腺神经内分泌癌患者的发病年龄低于国外报道,该病预后与其他乳腺癌类型无明显差异,均与临床分期及病理分型有关。有关乳腺神经内分泌癌的治疗及预后仍需大样本及长时间的随访观察。 相似文献
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《中国肿瘤临床与康复》2014,(5)
<正>乳腺神经内分泌癌是罕见的乳腺癌类型,仅占乳腺癌的2%5%。目前,关于乳腺神经内分泌癌的报道结果不一。我们对收治的41例乳腺神经内分泌癌患者临床病理特征进行分析,探讨其发病特点、临床病理特征及预后。一、资料与方法1.一般资料:收集中山大学肿瘤防治中心和厦门大学附属第一医院2004年4月至2013年2月间收治的、经病理确诊的乳腺神经内分泌癌患者41例,诊断标准为:至少有 相似文献
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目的 探讨乳腺原发性神经内分泌癌的临床病理特征,以加深对其认识。方法光镜观察13例乳腺神经内分泌癌的组织学特征,用En Vision法进行神经内分泌标记物(CgA、Syn和NSE)等免疫组化染色。结果13例女性,年龄43-79(平均66.5)a,60a以上9例(69.2%)。肿瘤直径1.2-3.0(平均1.65)cm。组织学类型为1例神经内分泌型导管原位癌,11例为实性型(2例形态似粘液癌,9例与浸润性导管癌形态交叉重叠),1例为小细胞型。全部病例50%以上肿瘤细胞表达2种以上的神经内分泌标记物。11例ER、PR阳性,不足半数病例表达P53、C-erbB-2,多数病例Ki-67表达指数较低。临床分期为12例Ⅰ期,1例ⅡA期。11例术后随访时间9-100(平均42)mo,均无肿瘤复发转移。结论乳腺神经内分泌癌好发于老年妇女。在形态上呈多向性,与普通型乳腺癌交叉重叠。在临床上预后较好。 相似文献
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目的:探讨乳腺神经内分泌癌(NEBC)的临床特点、诊断及治疗。方法对10例NEBC患者进行回顾性分析,并对其进行随访和分析。结果10例NEBC患者中,9例为女性患者,1例为男性患者。10例患者发病年龄为33~78岁,中位发病年龄为51岁。NEBC临床表现及影像学检查无特征性表现。有7例患者行改良根治术,2例患者行保乳术,1例患者确诊为乳腺神经内分泌癌后,未行手术治疗。其中,有3例患者腋窝淋巴结受累。NEBC的雌激素受体(ER)和孕激素受体(PR)阳性表达率分别为60%(6/10)和50%(5/10),人类表皮生长因子受体2(HER-2)阳性表达率为20%(2/10)。神经内分泌标志物嗜铬素A(ChrA)和突触素(Syn)至少有一项为阳性,阳性表达率分别为70%(7/10)和80%(8/10)。随访期间,5例患者出现转移,6例生存,3例患者死亡原因与乳腺癌相关,1例患者死于结肠癌消化道梗阻。结论本组NEBC患者发病年龄低于国外,临床表现及影像学检查并无特征性表现。NEBC作为一种少见但具有侵袭能力的肿瘤,应对其进行长期随访观察并制定有效的治疗措施。 相似文献
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乳腺神经内分泌癌是乳腺癌的一种少见类型,其在形态和表型上常呈多向性,神经内分泌指标呈阳性表达。全文分析5例乳腺神经内分泌癌的临床表现、组织学特征和免疫表型,总结临床病理特点。 相似文献
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目的:探讨不同病理亚型胃神经内分泌癌的临床病理特征、预后及影响因素。方法:收集2011年08月至2020年08月我院收治的经病理确诊的127例胃神经内分泌癌患者的临床资料。按病理类型分类,其中胃神经内分泌癌(gastric neuroendocrine carcinoma,G-NEC)102例,胃混合型神经内分泌-非神经内分泌肿瘤(gastric mixed neuroendocrine-non-neuroendocrine neoplasm,G-MiNEN)25例。t检验或卡方检验比较两组之间的临床病理特征;单因素生存分析采用Kaplan-Meier法和Log-rank检验,多因素生存分析采用Cox比例风险模型。结果:G-NEC和G-MiNEN患者在初次确诊时的TNM分期和有无远处转移方面均有差异,差异有统计学意义(P均<0.05)。G-NEC和G-MiNEN患者初次活检病理结果准确性分别为50.00%(51/102)和8.00%(2/25)。G-NEC和G-MiNEN患者中位生存时间分别为15.0(7.0~26.0)月、23.0(10.5~26.0)月,差异有统计学意义(P<0.05)。年龄、N分期、M分期和治疗方式的选择是患者预后的独立影响因素。结论:与G-MiNEN相比,G-NEC确诊时TNM分期更高、手术率低、中位生存期更短,而G-MiNEN则存在胃镜病理确诊率偏低的问题。年龄、N分期、M分期和治疗方式是胃神经内分泌癌患者预后的独立影响因素。 相似文献
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《Cancer radiothérapie》2015,19(5):308-312
PurposeThe aim of the present study was to discuss the epidemiology, clinical and pathologic features, treatment, and prognosis of primary neuroendocrine carcinomas of the breast.Patients and methodsWe report 21 cases diagnosed over a period of 12 years (1995–2011) at the university hospital of Sfax. A review of the clinical data with pathology and immunohistochemistry study was carried out for all the cases.ResultsThe average age was 62 years (34–86 years). At the time of the diagnosis, tumours were classified T1 and T2 (16 cases), N1 (11 cases) and M1 in two cases. The histological examination has shown 13 cases of solid neuroendocrine carcinoma, six cases of large cell type and two cases of atypical carcinoid. Grade I and II SBR were found in 18 cases. Eighty-one percent of the tumours were reactive for synaptophysin; all tumours were positive for chromogranin. Thirteen (61.9%) tumours were estrogen receptor-positive and 12 (57.5%) progesterone receptor-positive. Nineteen (90.5%) tumours were negative for HER2/neu. Overall five-year survival was 72.7%. All patients had surgical treatment with modified radical mastectomy in 13 cases. Adjuvant treatment was indicated according to histopronostic elements.ConclusionFor primary neuroendocrine carcinoma of the breast, multivariate analysis identified three predictive factors for mortality: disease stage, histological grade and lymph node involvement. 相似文献
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目的 探讨原发性腹膜后神经内分泌癌(NEC)的临床特点以及诊治经验.方法 对2000年1月至2012年1月收治的5例原发腹膜后NEC患者的临床资料进行回顾性分析.结果 5例患者中男4例,女1例,中位年龄53岁.3例患者以腹部不适伴疼痛为初始症状,2例患者术前无任何不适主诉和异常体征.术前均行B型超声及CT等影像学检查,1例误诊为胰头占位,1例误诊为胰岛细胞瘤且与周围组织关系密切,初始行动脉化疗栓塞2次.5例患者的血清学标志物癌胚抗原(CEA)及血清糖类抗原199(CA199)、CA242均正常;均行手术治疗,2例行根治性腹膜后肿物切除术,1例二次手术后行姑息性肿瘤切除术,2例术中探查肿瘤不可切除,行胃-空肠及空肠-空肠吻合术.2例患者明确病理分型为小细胞NEC,3例术中取少许组织行活组织检查,证实为NEC.5例患者均获得术后随访,术后3年生存2例.结论 腹膜后NEC临床罕见,肿瘤侵袭性强且恶性程度高,根治性手术切除率低,以手术为主的综合治疗仍是目前临床上的首选治疗手段.此类患者的早期诊断仍有待于进一步提高. 相似文献
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背景与目的:实性乳头状癌(solid papillary carcinoma,SPC)是乳腺癌的少见类型,不足乳腺癌的1%。作为乳腺乳头状癌的特殊亚型,SPC表现为实体结节状或膨胀性生长。本研究探讨乳腺SPC的临床病理特征、免疫表型特点及预后。方法:收集32例SPC的患者资料,进行病理组织学观察,免疫组织化学染色(EnVision法)检测ER、PR、C-erbB-2、p63、Calponin、CK5/6、Ki-67、Syn和CgA。结果:32例均为女性,平均年龄67.3岁,主要表现为乳头血性溢液和乳腺肿块。大体观察肿瘤呈结节状,灰褐色或灰白色,质地偏中或软。镜下肿瘤呈实体状或乳头状,实性区内见纤细的纤维血管轴心。肿瘤细胞呈卵圆形、多角形、梭形或印戒样,细胞质丰富嗜酸性,细胞核轻度或中度异型。免疫组化结果显示,所有患者肿瘤细胞ER和PR均强阳性(++~+++),C-erbB-2均无表达,实性结节内肿瘤细胞均不表达CK5/6、p63和Calponin。Syn和CgA阳性表达率分别为68.8%和78.2%。Ki-67平均阳性指数为7.5%(2%~20%)。27例获得随访资料,随访时间6~84个月,25例患者无瘤生存。1例患者术后复发,再次手术后生存至今,1例患者因发生转移而死亡。结论:乳腺SPC好发于老年女性,具有独特的组织学形态和免疫表型。SPC具有较为惰性的生物学行为,即使伴有浸润切除后也不易复发和转移,预后较好。 相似文献
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男性乳腺癌的诊断与治疗 总被引:21,自引:0,他引:21
目的探讨男性乳腺癌的诊断与治疗方法。方法回顾性总结男性乳腺癌32例,中位年龄54岁。分析了男性乳腺癌的诊断、治疗及预后。结果临床Ⅰ期7例,Ⅱ期17例,Ⅲ期7例,Ⅳ期1例。32例患者中,31例有乳腺肿块。腋窝淋巴结转移率57.1%。总5年生存率65.6%,根治术与改良根治术后患者5年生存率分别为68.4%及66.7%,非根治术患者5年生存率为57.1%。结论对于确诊为乳腺癌患者首选改良根治术根据患者不同情况辅以放射治疗、化疗或内分泌治疗 相似文献
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BACKGROUND: The nosology of neuroendocrine neoplasia has evolved substantially in recent years. The aim of this study was to review the authors' institutional experience and diagnostic accuracy for cytologic specimens of neuroendocrine carcinoma (NEC) and to identify features most suggestive of neuroendocrine differentiation. METHODS: The cytologic and histologic findings of 29 archival NEC in which cytology preceded biopsy or resection were compared. The study was comprised of 6 carcinoid tumors, 3 atypical carcinoid tumors, 17 high grade NEC (5 small cell, 9 large cell, and 3 mixed small/large cell), and 3 combined NEC/nonneuroendocrine carcinomas. Cytologic material was derived from 21 fine-needle aspirates (FNA), 6 bronchial brushing/washings, and 2 gastrointestinal tract brushings. RESULTS: Of the 29 cases, the correct cytologic diagnosis was rendered in 11. Two cases were identified as NEC but were graded incorrectly. The remaining 16 cases were interpreted as nonsmall cell carcinoma (8 cases); diagnostic or suspicious of carcinoma, not otherwise specified (7 cases); and atypical, indeterminate for malignancy (1 case). On review, neuroendocrine features were identified in 14 of the latter 16 cases. CONCLUSIONS: The cytologic diagnosis of NEC, both high and low grade, can be difficult. Because of acinus-like formations and columnar cell shapes, low grade NEC may be mistaken for adenocarcinoma. Small cell carcinomas, especially in bronchial brush and wash preparations, may be difficult to classify beyond malignant. Large cell NEC may be confused with nonneuroendocrine carcinomas because of abundant cytoplasm and nucleoli. Attention to the presence of loose cell aggregates in a background of singly dispersed cells; feathery patterns created by tumor cells clinging to capillaries; rosette formations; delicate, granular cytoplasm; inconspicuous nucleoli; molding in high grade tumors; and, most important, speckled or dusty chromatin patterns are useful in identifying neuroendocrine differentiation in cytologic specimens. 相似文献
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目的:分析河南地区神经内分泌肿瘤(neuroendocrine neoplasm,NEN)的流行病学和病理学特征,为NEN的防治提供依据。方法:回顾性调查2010年1月至2015年12月经河南省人民医院病理科确诊的NEN患者,综合分析其流行病学及病理学特征。结果:共检出NEN患者218例,总检出率为0.09%;年检出率的差异具有统计学意义(P<0.05);男性117例,女性101例,比例为1.16∶1;平均年龄(51.19±13.97)岁,男性平均年龄(52.86±13.10)岁,女性平均年龄(49.24±14.76)岁。三种病理类型中神经内分泌瘤(NET)104例(47.71%),神经内分泌癌(NEC)107例(49.08%),混合性腺神经内分泌癌(MANEC)7例(3.21%),不同性别NEN的病理类型差异无统计学意义(P>0.05)。NEN高发年龄为40~69岁,不同年龄段的NET和NEC差异有统计学意义(P<0.05)。病变部位以胰腺(22.02%)最为常见,其次为肺(15.14%),小脑、鼻、喉部、宫颈、卵巢等其他部位较罕见,除甲状腺外,不同性别在病变部位上的差异无统计学意义(P>0.05)。肿瘤组织标本的取得方式中以传统的手术为主(51.38%),其次是内镜方式(44.49%)。嗜铬蛋白A(CgA)染色阳性156例(71.56%);突触素(SYN)染色阳性203例(93.12%);NET、NEC中SYN阳性率均高于CgA阳性率,差异具有统计学意义(P<0.05)。结论:河南地区NEN的检出率近年呈上升趋势,熟悉其流行病学和病理学特征对早期诊断、防治及降低该地区NEC的发生具有重要的意义。 相似文献
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The urinary excretion of nonesterified cholesterol (NEC) in 170 women with cervical and endometrial carcinomas has been investigated. Control patients (236) included: 1) women with other types of (benign and/or malignant diseases of the pelvic organs; 2) patients with non-steroid-related neoplasms; 3) patients with benign and/or malignant breast diseases other than carcinoma; and 4) patients with a variety of non-neoplastic diseases. NEC was determined by a gas-liquid chromatographic procedure. The range of NEC excretion for clinically healthy normal women (64) was previously established by this method. NEC hyperexcretion was defined as any NEC value over 1.5 mg/24 hours. The results showed NEC hyperexcretion in 65 of 68 women with active carcinoma of the cervix, including 13 patients with carcinoma in situ, and in 42 of 45 women with active carcinoma of the endometrium. In contrast, a normal excretion of NEC occurred in all the patients (77) of the first and second control groups, in 39 (80%) of the 48 patients of the third control group (high-risk group), and in 101 of the 111 patients of the fourth control group. Sequential studies performed in patients with uterine carcinomas have demonstrated an almost perfect correlation between the NEC excretion and the clinical status of the patient following surgical and/or radiation therapy. Of 57 patients (31 cervix and 26 endometrium) in which the NEC studies were started after treatment was instituted, 53 have normal NEC excretion in the multiple determination performed to date. Presently these patients have no clinical, chemical, or radiologic evidence of cancer. It is concluded that urinary NEC determination can be used as an additional diagnostic biochemical test to detect active carcinoma of the steroid-producing glands and their main target organs, and that in women with uterine carcinomas, the test can be used as an objective laboratory method to monitor the course of the disease and the response of the patient to therapy. 相似文献