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目的:探讨胃神经内分泌肿瘤的临床及病理特点,减少误诊误治。方法:对所获军事医学科学院附属医院病理科诊断为胃神经内分泌肿瘤1例病例的临床及病理资料进行回顾性分析。结果:本例胃镜检查示贲门、胃底、胃体近贲门部不规则肿物增生隆起,大小约12.0 cm×7.0 cm,质较硬,边缘不齐,病理诊断为胃腺癌,分化Ⅱ~Ⅲ级。后经我院病理会诊及免疫组化结果证实为高增殖活性神经内分泌肿瘤(NET),伴坏死。结论:胃活检标本较小,同时取材钳夹时可能造成原有细胞形态及排列的破坏,较容易误诊。因此,应加强对HE切片的观察,并利用免疫组化技术验证诊断及鉴别诊断,同时结合临床病史、综合影像学检查给出诊断意见,以避免或减少误诊误治。
Objective: To investigate the clinical and pathological features of gastric neuroendocrine tumors and to reduce misdiagnosis and mistreatment. Methods: The clinical and pathological data of one case of gastric neuroendocrine tumor diagnosed by Department of Pathology, Affiliated Hospital of Academy of Military Medical Sciences were retrospectively analyzed. Results: The gastroscopy in this case showed irregular enlargement and enlargement of the cardia, fundus and corpus near the cardia with a size of about 12.0 cm × 7.0 cm. The quality was hard, the margin was not homogeneous, and the pathological diagnosis was gastric adenocarcinoma. Differentiation Ⅱ ~ Ⅲ level. After the pathological consultation by our hospital and immunohistochemical results confirmed high proliferative activity of neuroendocrine tumors (NET), with necrosis. Conclusion: The gastric biopsy specimens are small, and the same time taking the clamp may cause the destruction of the original cell morphology and arrangement, easier misdiagnosis. Therefore, we should strengthen the observation of HE slices, and use immunohistochemistry to validate the diagnosis and differential diagnosis, combined with clinical history, comprehensive diagnostic imaging diagnosis given to avoid or reduce misdiagnosis and mistreatment.