胃神经内分泌癌和胃癌伴神经内分泌分化的临床病理研究

目的：探讨胃神经内分泌癌和胃癌伴神经内分泌分化的临床病理特征。方法：回顾12例胃神经内分泌癌和8例胃癌伴神经内分泌分化的临床病理资料及苏木精-伊红染色切片，并作神经内分泌标记物(CgA、syn、NSE等)的免疫组化染色和AB/PAS组化染色。结果：两组患者均以老年男性为主，肿块大多为溃疡型，多位于胃贲门部或胃窦部。12例胃神经内分泌癌中，典型类癌2例、不典型类癌9例、低分化神经内分泌癌1例，大部分癌细胞均表达神经内分泌标记物，其中7例不典型类癌内见少数腺癌或粘液细胞癌成分，后二者阳性表达CEA和PAS。8例胃癌伴神经内分泌分化者见少数神经内分泌标记物阳性的细胞散在分布于胃癌组织内。结论：胃神经内分泌癌和胃癌伴神经内分泌分化属不同的组织学类型，免疫组化染色可明确区分二者。

Gastric neuroendocrine carcinoma and gastric carcinoma with neuroendocrine cell differentiation: a clinicopathological and immunohistochemical study

s: Objective:To investigate the clinicopathological characteristics of gastric neuroendocrine carcinoma(GNEC) and gastric carcinoma with neuroendocrine cell differentiation(GCNEC). Methods:The clinical and pathological data, and HE stained slides of twelve GNEC patients and eight GCNEC patients were reviewed. Immunohistochemical studies and Alcian blue/periodic acid Schiff(AB/PAS) stains were performed. Results:Most patients from the 2 groups were old males. Most tumors were located in the cardia or antrum. Two typical carcinoids, 9 atypical carcinoids and 1 poorly differentiated NEC were identified among 12 cases of GNEC. Most of the tumor cells expressed neuroendocrine markers(including CgA, syn and NSE). Seven atypical carcinoids demonstrated a few glandular or acinar architecture and mucous cell carcinoma which expressed CEA and were PAS positive staining. Eight GCNEC were demonstrated with dispersed neuroendocrine cells which also expressed neuroendocrine markers. Conclusions:GNEC and GCNEC are two different histopathological entities. Immunohistochemical stain makes differentiation possible.