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混合性神经内分泌-非神经内分泌肿瘤7例临床病理分析

Clinicopathological study of 7 cases with mixed neuroendocrine-non-neuroendocrine neoplasms

    摘要
  • 摘要:
      目的  探讨混合性神经内分泌-非神经内分泌肿瘤（MiNEN）的临床病理学特征。
      方法  收集7例MiNEN患者的临床资料，观察病理组织学形态及免疫组化标记，分析其临床病理学特征及预后。
      结果  7例患者中，男5例，女2例，年龄48~83岁，病变发生部位为食管1例、胃3例、十二指肠1例、直肠1例、胰腺1例。食管病变镜下为鳞状细胞癌和高级别神经内分泌瘤（NET G3），胃、十二指肠、直肠病变镜下非神经内分泌肿瘤成分均为腺癌，神经内分泌肿瘤成分为小细胞癌（3例）、大细胞癌（1例）、NET G3（1例），胰腺病变镜下为导管腺癌和低级别神经内分泌瘤（NET G1）。非神经内分泌肿瘤成分（鳞状细胞癌或腺癌）相应的上皮性免疫组化标记结果均为阳性；神经内分泌肿瘤成分中，CKpan阳性、Syn阳性7例，CD56阳性6例、阴性1例，CgA阳性6例、阴性1例，Ki67为1%~80%阳性。7例患者中，3例有淋巴结转移，随访时间3~33个月，5例存活，2例死亡。
      结论  MiNEN是一种少见的肿瘤，正确诊断对临床治疗及预后评估具有重要意义。

     

    Abstract:
      Objective  To study the clinicopathologic features of mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN).
      Methods  The medical records of 7 MiNEN cases were collected. The histopathological morphology was observed, the histopathological and immunohistochemical were labeled, and the clinicopathologic features and prognosis were analyzed.
      Results  Among 7 cases, there were 5 males and 2 females, aged 48 to 83 years. The neoplasm of 1 case located in esophagus, 3 in stomach, 1 in duodenum, 1 in rectum, and 1 in pancreas. Microscopy showed that the tumor of esophagus was squamous cell carcinoma and neuroendocrine tumor(NET G3). Non-neuroendocrine tumors of stomach, duodenum, rectum were adenocarcinoma, and their neuroendocrine tumors were small cell carcinoma (3 cases), large cell carcinoma (1 case), and NET G3 (1 case), and tumors of pancreas showed it belonged to ductal carcinoma and neuroendocrine tumor(NET G1). Non-neuroendocrine tumors (squamous cell carcinoma or adenocarcinoma) showed positive epithelium by immunohistochemical staining; there were 7 cases with positive CKpan and Syn of neuroendocrine tumor, 6 cases of positive CD56 and 1 case of negative CD56. The percentage of patients with positive Ki67 protein was 1%to 80%. Three of seven cases had lymph node metastasis. The follow up lasted for 3 to 33 months. During follow-up, 5 patients were alive and 2 died.
      Conclusion  MiNEN is an uncommon neoplasm. Correct diagnosis is important for clinical treatment and prognosis.

     

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