摘要
AIMS To elucidate the biological and clinicopathological signifi- cance of neuroendocrine(NE)cells in gastric carcinoma(GC). METHODS One hundred and eighty-nine cases of various histo- logical types of GC were observed using light microscopy, histochemistry,immunohistochemistry and electron microscopy. Of them 127 patients were followed up. RESULTS Chromogranin A(CgA)positive GC was demonstrat- ed in 85 cases(45.0%).The typos of NE cells in GC were probed using 9 kinds of hormone antibodies 49 cases(67.2%) contained more than one hormone.NE cells were found more often in poorly differentiated GC than in well differentiated ones(P<0. 01).Expression of some kinds of hormone Was relative to the dif- ferentiation and histological types of GC.BOM,CT(P<0.01) GAST and 5-HT(P<0.05)were more expressed in poorly differ- entiated cases than in well defferentiated ones.Nineteen cases of the matastatic foci in regional lymph nodes were found to have CgA positive cancer cells.The presence of HCG in matastatic lymph nodes was more often observed than that of other hormone (P<0.01).The survival rate of patients with NE positive GC was 38.9% and negative GC 52.7%.Five of 7 patients(71. 4%)with somatostatin positive GC still survived at follow up of 33-66 months,but 4 patients with HCG positive GC died in 12-29 months. CONCLUSIONS The NE cells occur more frequently in poorly differentiated GC.Certain hormones appear to be related to the metastasis and prognosis.
目的探讨胃癌中神经内分泌(NE)细胞的生物学及临床病理意义。方法应用光镜、组化、免疫组化、透射电镜对189例各组织学类型胃癌的 NE 细胞进行观察,并对其中127例患者进行随访。85例检出 CgA 阳性癌细胞(45.0%)。其中73例进一步做各类激素抗体检测。结果所采用的9种激素抗体在胃癌组织中均有阳性表达。85例检出 CgA 阳性癌细胞,其中49例表达2种及以上激素。NE阳性癌细胞多出现在分化差的胃癌组织学类型中(P<0.01)。某些激素种类的表达与胃癌组织学类型及分化关系较密切。BOM、CT(P<0.01),GSAT、5.HT(P<0.05)多存在于分化差的癌中。不同的 NE 细胞其 NE 颗粒形态不同。NE 阳性胃癌组40例的淋巴结转移癌灶中19例有转移 NE 阳性细胞,其中13例 HCG 表达阳性(68.4%),明显高于其他激素的阳性表达(P<0.01)。NE 细胞阳性胃癌患者组存活率为38.9%;阴性组52.7%。4例 HCG 阳性胃癌患者随访12—29个月全部死亡,而7例生长抑素阳性胃癌患者随访33-66个月还有5例存活。结论胃癌中某些 NE 细胞在分化差的癌中检出率较多,不同种类的激素对胃癌侵润转移及预后可能有不同的影响。
