8例散发性胃类癌的临床分析及免疫组化

Eight cases of dispersed gastric carcinoid:clinical analysis and histochemistry

目的为进一步提高对胃类癌的认识,有助于今后对该病的诊断及治疗。方法将华山医院2000-2005年以来经胃镜及术后病理证实且临床资料完整的8例胃类癌病例予以分析总结。对患者的一般情况、临床表现、内镜下表现、病理及免疫组化染色结果、血清肿瘤标志物、手术方式及术后生存情况作统计分析。结果胃类癌的早期临床表现隐匿,3/8的病例是因体检或胃窦炎例行随访胃镜时发现的。4/8首发症状为消化道出血,未见伴有类癌综合征。8例标本Chromograin A、CK、NSE免疫组化染色均为阳性。7例患者血清CEA、CA19-9、CA72-4、CA125、CA50、TSGF有一项以上不同程度的升高。所有患者均行内镜下黏膜大块切除术或胃癌根治术,目前7例尚存活。结论加强体检和内镜随访是早期发现胃类癌的根本办法。血清肿瘤标志物联合检测及特殊免疫组化染色可为诊断提供有力的支持。内镜下黏膜大块切除术或胃癌根治术可改善患者的预后。

Purpose Try to improve the diagnosis and treatment of gastric carcinoid in the future. Methods A retrospective study of 8 cases of gastric carcinoid diagnosed in Huashan hospital was performed. The materials of general conditions, clinical features, endoscopic findings, serum tumor marks, operation methods, pathological and immunohistochemistry results, survival rates were collected and analyzed Results The clinical symptom of gastric carcinoid was obscure and the carcinoid syndrome was scarce. Three cases were confirmed by routine health examination and gastroscopy follow-up. Seven cases were abnormal in serum tumor marks test（such as CEA, CA19-9, CA72-4, CA125, CA50, TSGF）. All cases showed positive of immunohistochemistry staining in Chromograin A,CK and NSE. Endoscopic mucoresection or radical gastrectomies were taken in these cases and seven of them are still survive at present. Conclusions The routine health examination and combined test of serum tumor marks are important for early diagnosis. Biopsies under gastroscopy and immunohistochemistry stain make the diagnosis more reliable. Endoscopic mucoresection or radical gastrectomy is the optimal choice for treatment, which may ameliorate the prognosis.