食管小细胞癌的临床病理分析

Clinicopathologic Observation on Small Cell Carcinomaof the Esophagus

目的:探讨食管小细胞癌的组织起源、生物学特性以及影响其预后的相关因素。方法:应用多种免疫组织化学检测的方法对63例食管小细胞癌进行了广谱细胞角蛋白(CK)、神经元特异性烯醇化酶(NSE)、嗜铬粒-A(CHr-A)、突触素(Syn)和CD56的检测。结果:63例食管小细胞癌,光镜下分为单一型小细胞癌(28/63)和混合型小细胞癌(35/63)。CK、NSE、CHr-A、Syn和CD56的阳性率分别为41.3%、36.5%、90.5%、60.3%和50.8%。5种抗体在单一型小细胞癌和混合型小细胞癌中的阳性表达情况比较(P>0.05),差别无显著性意义。影响预后的主要因素是肿瘤体积、浸润深度、残端(+)和瘤栓及淋巴结转移,与组织学类型及有无神经内分泌表达无关。结论:食管小细胞癌为高恶度肿瘤,对神经源性特异性抗体表达有明显的亲和性;其组织来源尚难定论,本研究倾向于非神经上皮源性。

Objective: To investigate the histogenesis and biological characteristics and factors influencing prognosis of the small cell carcinoma of the esophagus. Methods: Expression of five protein which consist of CK, NSE, CHr-A, Syn, and CD56 was examined immunohistochemically in 63 cases of the small cell carcinoma of the esophagus. Results: Sixty-three cases of the small cell carcinoma of the esophagus was divided into two types, ie pure small cell (28/63)and compound small cell (35/63). The result of immunohistochemistry showed: CK in 41.3%, NSE in 36.5%, Syn in 90.5%, CHr-A in 60.3% and CD56 in 50.8%. In statistics,the expression of five antibodies in pure small cell carcinoma and in compound small cell carcinoma is undistinguishable. The bulk of the tumor and the depthe of tumor invasion and the positive end to end of the tumor and lymphnode metastasis were the major determinants influencing long-term survial. Conclusion: Small cell carcinoma of the esophagus is a kind of high malignant tumors, which highly express neuroendocrine antigene. The histophathologic origin is still uncertain. But this study has been adoptive to the epicyted origin.