论文部分内容阅读
目的:探讨原发性食管神经内分泌肿瘤的病理特征及临床诊断模式。方法:回顾性分析2001年1月至2010年12月在本科接受治疗的32例原发性食管神经内分泌癌的临床影像学诊断方法、病理特征。结果:32例原发性食管神经内分泌癌中,小细胞癌27例(84.38%,27/32),不典型类癌4例(12.5%,4/32),类癌1例(3.13%,1/32);影像学(螺旋CT或PET/CT检查)评估可手术患者的临床TNM分期(TNM staging),手术后病理TNM分期(Pathological TNM staging,pTNM分期)上调的占本组患者总数的12.5%(4/32),主要为3例术前评估为T_3的患者术中见为侵犯外膜(T_4),另1例术前为T_2NOMO患者术后有单站纵隔淋巴结转移(N1);免疫组化提示肿瘤细胞表达嗜铬素A(CgA)、肿瘤细胞表达突触素(Syn)、神经特异性烯醇化酶(NSE)等单种或多种分化标记物呈阳性表达。结论:原发性食管神经内分泌癌特别是小细胞癌恶性程度高,综合多部位的增强CT或PET/CT等多种影像学检查手段有助于临床分期,病理检查中联合CgA、Syn、NSE等多种分子标记有助于明确诊断。
Objective: To investigate the pathological features and clinical diagnosis of primary esophageal neuroendocrine tumors. Methods: The clinical imaging diagnosis and pathological features of 32 patients with primary esophageal neuroendocrine carcinoma who were undergraduate from January 2001 to December 2010 were retrospectively analyzed. Results: Among the 32 cases of primary esophageal neuroendocrine carcinoma, there were 27 cases of small cell carcinoma (84.38%, 27/32), 4 cases of atypical carcinoid (12.5%, 4/32) and 1 case of carcinoid carcinomas (3.13% 1/32). Imaging (spiral CT or PET / CT) was used to assess the clinical TNM staging in operable patients. The total number of patients with pathological TNM staging (pTNM staging) 12.5% (4/32), mainly 3 cases of preoperative T_3 in patients with surgery to see violations of the outer membrane (T_4), the other one case of preoperative T_2NOMO patients with single mediastinal lymph node metastasis (N1); Immunohistochemistry showed that tumor cells expressed single or multiple differentiation markers such as chromogranin A (CgA), synaptophysin (Syn) and neuron specific enolase (NSE). Conclusions: Primary esophageal neuroendocrine carcinomas, especially small cell carcinoma, have high malignant degree. Combined with multi-site enhanced CT or PET / CT imaging, it is helpful to clinical staging and pathological examination in combination with CgA, Syn, NSE A variety of molecular markers help to confirm the diagnosis.