胃混合性腺神经内分泌癌的临床病理特征分析

Clinic Opathological Features of Mixed Neuroendocrine Carcinoma of the Stomach

目的探讨胃混合性腺神经内分泌癌(MANEC)的临床病理特征及其诊治方法。方法回顾性分析该院在2015年9月—2016年9月诊治的11例胃混合性腺神经内分泌癌患者的临床病理资料,分析其诊治及预后。结果 11例患者中,男性5例,女性6例,平均年龄67.18岁;肿瘤位于贲门胃体6例,胃体2例,胃窦3例;免疫组化结果 Cg A(+)1例,Syn(+)6例,Cg A及Syn均(+)4例;11例患者的Ki67指数均>20%;11例患者均接受手术治疗,其中全胃切除5例,近端胃切除2例,远端胃切除4例。结论胃混合性腺神经内分泌癌是一种较罕见的特殊类型胃恶性肿瘤,预后差,其临床表现缺乏特异性,病理免疫组化是主要确诊手段,手术切除是主要治疗手段。

Objective This paper tries to investigate the clinicopathologic features and diagnosis and treatment of the gastric mixed adenoneuroendocrine carcinoma（MANEC）. Methods The clinical pathological data of 11 cases of gastric cancer patients with mixed adenoneuroendocrine in this hospital from September 2015 to September 2016 were retrospectively analyzed, the diagnosis and prognosis were analyzed as well. Results Among the 11 cases of patients, 5 cases were male, 6 were female, mean age was 67.18 years old; 6 cases of cardiac tumors located in the gastric body, 2 cases of gastric body, 3 cases of gastric antrum; 1 case of immunohistochemical results of CgA（＋）,6 cases of Syn（＋）,4 cases of CgA（＋） and Syn（＋）respectively; 11 cases of Ki 67 index〉 20%; 11 patients underwent surgical treatment, 5 patients underwent total gastrectomy, 2 cases of proximal gastrectomy, 4 cases of distal gastrectomy. Conclusion Gastric mixed adenoneuroendocrine carcinoma is a rare special type of gastric cancer, whose prognosis is poor and lack of specific clinical manifestations, pathology immunohistochemistry is the main means of diagnosis, and surgical resection is the main treatment method.