胃肠道神经内分泌肿瘤32例临床及病理分析

目的 分析胃肠道神经内分泌肿瘤的临床表现和病理特点,研究新的病理学分类方法,以提高对该类疾病的认识.方法 回顾性分析病理证实为神经内分泌肿瘤的胃肠道病变32例,对肿瘤进行常规镜检,并做免疫组化检测.比较不同类型肿瘤的发病年龄、分布部位、临床表现及组织病理特征.结果 32例患者可分为4型:高分化神经内分泌肿瘤G1 12例、高分化神经内分泌肿瘤G2 9例、神经内分泌癌9例和混合性腺神经内分泌癌2例.其中来自前肠15例,中肠8例,后肠9例.不同类型胃肠道神经内分泌肿瘤的病理表现各有不同.结论 胃肠道神经内分泌肿瘤临床表现不典型,病理学诊断是其最后确诊的主要方法,免疫组化的合理应用可提高神经内分泌癌的诊断率新的病理学分类方法更加客观准确.

Clinicopathological study of neuroendocrine neoplasms of gastrointestinal tracts

OBJECTIVE To study the variation of clinical and pathologic features as well as classifications of the neuroendocrine neoplasms of gastrointestinal tracts.METHODS The clinical and pathological data of 32 patients were analyzed retrospectively.All of them were stained immunochemically with CgA,NSE,CK,EMA and Syn,and observed under microscope.The ages,positions,clinical manifestations and histopathological features in different types were compared.RESULTS The 32 neuroendocrine neoplasms of digestive system were divided into four types:12 cases of neroendocrine tumours G1 /NET G1,9 cases of neroendocrine tumours G2 /NET G2,9 cases of neuroendocrine carcinomas /NEC,2 cases of mixed adenoneuroendocrine carcinomas /MANEC.The tumors originated from foregut,midgut and hindgut were 15,8 and 9 cases respectively.Different types of neuroendocrine neoplasms showed different pathologic features.CONCLUSION The syndromes of neuroendocrine neoplasms of gastrointestinal tracts are not typical.Pathology result is a gold standard.Reasonable application of immunohistochemical method may raise the diagnostic rate of neuroendocrine tumors.The new classification is more objective and accurate.