分泌粒蛋白Ⅱ在结直肠神经内分泌肿瘤中表达情况和临床分析

Expression and clinical analysis of secretory graninⅡin colorectal neuroendocrine tumors

目的探讨分泌粒蛋白Ⅱ(secretograninⅡ,SGⅡ)在结直肠神经内分泌肿瘤(colorectal neuroendocrine tumors,CRNETs)中的表达及诊断价值。方法采用免疫组织化学EnVision两步法检测SGⅡ、突触素(synapsin,Syn)、神经细胞粘附因子(neural cell adhesion molecule,CD56)、嗜铬素A(chromogranin A,CgA)及Ki-67在165例结直肠原发神经内分泌肿瘤(neuroendocrine neoplasms,NENs)及136例非神经内分泌肿瘤(non-neuroendocrine neoplasms,non-NENs)中的表达,比较神经内分泌标记表达的敏感度;并分析CRNETs中SGⅡ、Ki-67、CgA与临床病理特征的相关性。结果SGⅡ在CRNETs G1、G2、G3和NEC中的阳性率分别为97.2%(104/107),100%(40/40),100%(5/5),69.2%(9/13),高于non-NENs(1.47%,7/136)中的阳性率(P<0.05)。SGⅡ在CRNETs中的敏感度为95.8%(158/165),与Syn的98.8%(163/165)相当,高于CD56的84.2%(139/165)及CgA的33.9%(56/165),差异有统计学意义(P<0.05)。肿瘤直径、浸润深度、脉管侵犯、神经侵犯及淋巴结转移与SGⅡ的表达呈负相关,与Ki-67表达呈正相关,差异均有统计学意义(P<0.05),而CgA与以上肿瘤性状呈负相关,差异无统计学意义(P>0.05)。结论SGⅡ在结直肠神经内分泌肿瘤中高表达,是鉴别诊断CRNETs比较可靠的标志物,其表达与肿瘤直径、浸润深度、脉管侵犯、神经侵犯及淋巴结转移呈负相关。

Objective To investigate the expression and diagnostic value of secretograninⅡ(SGⅡ)in colorectal neuroendocrine tumors(CRNETs).Methods The expression of SGⅡ、Syn、CD56、CgA and Ki-67 were detected using immunohistochemical EnVision two-step method in 165 neuroendocrine neoplasms(NENs)and 136 non-neuroendocrine neoplasms.Results 1)The positive rates of SGⅡin CRNETs G1,G2,G3 and NEC were 97.2%(104/107),100%(40/40),100%(5/5),69.2%(9/13),respectively.Higher than the positive rate of non-NENs(1.47%,7/136)(P<0.05);2)The sensitivity of SGⅡin CRNETs was 95.8%(158/165),which was similar to Syn(98.8%(163/165),higher than that of CD56(84.2%(139/165)and CgA(33.9%).3)Tumor diameter,invasion depth,vascular invasion,nerve invasion and lymph node metastasis were negatively correlated with SⅡexpression and positively correlated with Ki-67 expression,with statistical significance(P<0.05),while CgA was negatively correlated with the above tumor traits,with no statistical significance(P>0.05).Conclusion SGⅡis highly expressed in colorectal neuroendocrine tumors,which is a reliable marker for the differential diagnosis of CRNETs.Its expression is negatively correlated with tumor diameter,invasion depth,vascular invasion,nerve invasion and lymph node metastasis.