胃癌伴神经内分泌分化和胃混合性腺神经内分泌癌临床病理及预后分析

　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　【摘要】目的 探讨胃癌伴神经内分泌分化和胃混合性腺神经内分泌癌的临床病理及预后。方法 回顾性分析61例胃癌伴神经内分泌分化和34例胃混合性腺神经内分泌癌患者的临床病理资料，对其组织化学及免疫组织化学染色进行观察。结果 胃癌伴神经内分泌分化和胃混合性腺神经内分泌癌患者肿瘤发病部位、远处转移及区域淋巴结转移差异有统计学意义（P<0.05）;SyN 、CgA和CD56三者阳性表达率差异有统计学意义（P<0.05）；区域淋巴结转移和远处转移2个因素与预后相关（P<0.05）；胃混合性腺神经内分泌癌患者术后生存期短于胃癌伴神经内分泌分化患者（P<0.05）。结论 免疫组化染色对胃癌伴神经内分泌分化和胃混合性腺神经内分泌癌的确诊具有重要意义，肿瘤神经内分泌细胞数量的多少对患者预后评估及辅助治疗有指导意义。

Analysia of clinicopathological features and prognosis of gastric carcinoma with neuroendocrine differentiation and mixed gonadal neuroendocrine carcinoma of the stomach

[Abstract] Objective To investigate the clinical pathological features and prognosis of gastric carcinoma with neu?roendocrine differentiation (NED) and mixed gonadal neuroendocrine carcinoma of the stomach (MANECs). Methods A retrospective analysis of61cases of gastric carcinoma with NED and34cases of MANECs and their histochemistry and im?munohistochemistry were also observed. Prognosis of the2groups were compared by the Kaplan-Meiers survival analysis. Prognostic factors associated with patients with gastric cancer were analyzed by COX proportional hazards model.Results Tumor location, distant metastasis and lymph node metastasis were statistically different between these2groups (P<0.05). Syn positive expression rate is higher than CgA and CD56in the gastric carcinoma with NED group; Postoperative survive pe?riod of the gastric carcinoma with NED is shorter than that of MANECs (P<0.05). Lymph node metastasis and distant region?al transfer is obviously correlated with prognosis (P<0.05). Conclusion Immunohistochemistry is important for the diag?nosis of these two tumor. The number of neuroendocrine cells can help to assess prognosis and guide treatment.