中国实用外科杂志 ›› 2010, Vol. 30 ›› Issue (07): 581-583.

• 论著 • 上一篇    下一篇

食管胃交界混合性外分泌-内分泌癌病理形态学观察

王占东1,王永军1,杨杰 3,许志宏2,王小玲1,吴国祥1,郭    明1   

  1. 1河北医科大学第四医院病理科,河北石家庄050011;2河北省沧州市河间市人民医院外二科,河北河间062450;3河北体育学院运动人体科学系,河北石家庄050041
  • 出版日期:2010-07-01 发布日期:2010-06-17

  • Online:2010-07-01 Published:2010-06-17

摘要:

目的    探讨食管胃交界混合性外分泌-内分泌癌的病理形态学特征。方法    2008年3月河北医科大学第四医院对60例食管胃交界癌利用synaptophysin、chromogranin和neuron-specific enolase(NSE)三种抗体进行免疫组化检测,筛出17例混合性外分泌-内分泌癌,进行病理形态学观察。结果    17例混合性外分泌-内分泌癌可以看到4种不同的组织形态学表现:分化好的腺管状、分化差的低分化腺癌样、印戒细胞样、 小细胞癌样。免疫表型:Synaptophysin在17例混合性外分泌-内分泌癌均呈阳性表达,且10例呈弥漫强阳性。10例同时伴有chromogranin表达,11例同时表达NSE,5例同时表达三种抗体。结论    食管胃交界混合性外分泌-内分泌癌并不少见,形态学上与印戒细胞癌、管状腺癌、低分化腺癌等存在许多相似之处,非常不易区别,需要依靠免疫组化进行检测,其生物学行为是否与腺癌存在明显差异,需要进一步研究。

关键词: 混合性外分泌-内分泌癌, 食管胃交界, 病理学观察, 免疫组织化学染色

Abstract:

Clinicopathologic diagnosis of mixed exocrine-endocrine carcinoma of the esophagogastric junction        WANG Zhan-dong*, WANG Yong-jun, YANG Jie, et al. *Department of  Pathology, Hebei University Fourth Hospital, Shijiazhuang 050011,China
Corresponding author:WANG Xiao-ling,E-mail:wangxiaoling5412@163.com
Abstract    Objective    To investigate the clinicopathological features of mixed exocrine-endocrine carcinoma (MEEC) of the esophagogastric junction. Methods    Seventeen cases of  MEEC were distinguished from 60 cases of cancer of the esophagogastric juntion by S-P immunohistochemical staining methods, with synaptophysin,chromogranin and neuron-specific enolase (NSE)  antibodies in March 2008 at Hebei University Fourth Hospital. Results    Seventeen cases of MEEC have differentiated four distinct tumors. The morphological types of the tumors were tublar adenocarcinoma,signet ring cell  carcinoma,poor differentiated adenocarcinoma and small cell carcinoma with neuroendocrine diffrentiation. Synaptophysin in 17 cases of mixed exocrine-endocrine carcinoma were positive, and 10 cases showed diffuse strong positive. Ten cases with chromogranin expression, and 11 cases with NSE expression, 5 cases expressed three antibodies. Conclusion    MEEC is a newly described entity, with only very few cases reported in the literature. More attention should be paid in the daily practice in order to differentiate the tumor from tublar adenocarcinoma, signet ring cell carcinoma and poor differentiated adenocarcinoma .The prognosis of  the tumor has not determined,which need more studied.

Key words: mixed exocrine-endocrine carcinoma , esophagogastric junction ;clinicopathology;immunohistochemistry