肝原发性与转移性神经内分泌肿瘤的临床病理分析

Primary and metastatic hepatic neuroendocrine carcinoma： a clinicopathoiogical study

目的探讨原发性和转移性肝神经内分泌肿瘤的临床病理特征以及两者的鉴别要点。方法收集35例肝原发性神经内分泌肿瘤（原发组）和35例肝转移性神经内分泌肿瘤（转移组）。对两组患者性别、肿瘤大小、肿瘤个数、发生部位、肿瘤分化程度、生长方式、坏死（有／无）、瘤栓（有／无）以及核分级和核分裂相10个指标进行对照分析，评估各项指标在两组间的分布差异。结果原发组有明显的男性发病优势（25比15；P〈0．05）。在肿瘤发生个数和大小的比较上原发组多为单发（n=30）并且肿块较大（平均直径8．4cm），转移组多个肿块多见（n=11）并且肿块较小（平均直径5．4cm）（P〈0．05）。原发组与转移组肿瘤，肝左右叶的分布无差异（P〉0．05），原发组肿瘤多位于单叶，转移组肿瘤多双叶同时发生（P〈O．05）。两组肿瘤组织病理形态学（肿瘤分化程度、生长方式、坏死、瘤栓、核分级及核分裂相）无显著差异（P〉0．05）。结论患者性别、肿瘤大小、发生部位、肿瘤个数这4项指标对于区别肝神经内分泌肿瘤是原发性还是转移性具有一定参考价值。

Objective To study the clinicopathological features of primary and metastatic hepatic neuroendocrine carcinoma. Methods The records of 35 patients with primary hepatic neuroendo- crine carcinoma and 35 patients with metastatic hepatic neuroendocrine carcinoma were retrospectively reviewed. These patients served as the primary group （priNET, n= 35） and the metastasis group （met NET, n=35）, respectively. Results There were significant differences between the two groups of patients in gender, site, size and number of tumor （P〈0.05）. Although there was no significant difference between the two groups in the distribution of the tumors in the two lobes of liver （P〉0.05）, priNET had more tumors localized to one lobe of liver while metNET had more tumors involving both lobes of liver （P〈0.05）. Conclusions Gender, size, site and number of tumor may play an important role in the differentiation of primary or metastatic hepatic neuroendocrine tumor.