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Clinicopathological,treatment,and prognosis study of 43 gastric neuroendocrine carcinomas 被引量:9
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作者 De-Jun Liu Xue-Liang Fu +7 位作者 Wei Liu Lu-Ying Zheng Jun-Feng Zhang Yan-Miao Huo Jiao Li Rong Hua Qiang Liu Yong-Wei Sun 《World Journal of Gastroenterology》 SCIE CAS 2017年第3期516-524,共9页
AIM To provide more information and therapeutic methods about gastric neuroendocrine carcinomas(G-NECs) which occur rarely but are highly malignant and clinically challenging.METHODS We retrospectively analyzed the cl... AIM To provide more information and therapeutic methods about gastric neuroendocrine carcinomas(G-NECs) which occur rarely but are highly malignant and clinically challenging.METHODS We retrospectively analyzed the clinicopathological characteristics, treatments, and prognosis of 43 G-NEC patients at our hospital between January 2007 and December 2014. The diagnosis was based on the 2010 World Health Organization criteria.RESULTS Forty-three G-NECs containing 39 small cell carcinomas and 4 large cell NECs with Ki67 > 60% were included in this study, accounting for only 0.95% of all gastric carcinomas. The median patient age was 62 years (range, 33-82) and the male-to-female ratio was 4.4:1. All patients underwent surgery, including 38 curative resections and 5 palliative resections. Among these 43 patients, nearly half(48.84%) of these tumors were located in the cardiac region of the stomach, regional lymph node metastasis was found in 31 cases(72.09%), and liver metastasis was found in 6 cases(13.95%). Follow-up information was got for 40 patients. Twentythree die of this disease with a median survival of 31 mo(range 1-90). The 1-year, 2-year, 3-year, and 5-year survival rate was 77.50%, 57.04%, 44.51%, and 35.05%, respectively. Survival was better in patients with tumor located in the cardiac region of the stomach, less than 7 lymph nodes metastasis and no liver metastasis. Five patients did not undergo postoperative chemotherapy, and the median survival time for these patients was 15 mo. For the remaining 34 patients who received postoperative chemotherapy, the median survival time was 44 mo and those received etoposide, cisplatin, and Paclitaxel survived the best. One patient with resected liver metastasis who received postoperative Capecitabine plus Oxaliplatin and Paclitaxel systemic chemotherapy plus octreotide LAR(30 mg intramuscularly, every 4 wk, for 2 years) has survived for 74 mo with no recurrence.CONCLUSION G-NECs are mostly nonfunctioning, which lead to a delay in detection. Local and/or distant metastases were noticed in most patients when diagnosed, and they required postoperative medical treatment. Adjuvant etoposide, cisplatin plus Paclitaxel systemic chemotherapy is recommended for these patients. 展开更多
关键词 gastric neuroendocrine carcinomaS Liver metastasis Medical TREATMENT Surgery PROGNOSIS
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Clinical significance of programmed death 1/programmed death ligand 1 pathway in gastric neuroendocrine carcinomas 被引量:3
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作者 Min-Wei Yang Xue-Liang Fu +12 位作者 Yong-Sheng Jiang Xiao-Jing Chen Ling-Ye Tao Jian-Yu Yang Yan-Miao Huo Wei Liu Jun-Feng Zhang Pei-Feng Liu Qiang Liu Rong Hua Zhi-Gang Zhang Yong-Wei Sun De-Jun Liu 《World Journal of Gastroenterology》 SCIE CAS 2019年第14期1684-1696,共13页
BACKGROUND Recently, more and more studies have demonstrated the pivotal role of programmed death 1/programmed death ligand 1(PD-1/PD-L1) pathway in the immune evasion of tumors from the host immune system. However, t... BACKGROUND Recently, more and more studies have demonstrated the pivotal role of programmed death 1/programmed death ligand 1(PD-1/PD-L1) pathway in the immune evasion of tumors from the host immune system. However, the role of PD-1/PD-L1 pathway in gastric neuroendocrine carcinomas(G-NECs) remains unknown.AIM To investigate the expression of PD-1/PD-L1 and role of PD-1/PD-L1 pathway in G-NECs, which occur rarely but are highly malignant and clinically defiant.METHODS We investigated the expression of PD-L1 on tumor cells and PD-1^+, CD8^+, and FOXP3^+ T cell infiltration by immunohistochemistry in 43 resected G-NEC tissue specimens. The copy number alterations of PD-L1 were assessed by qRT-PCR.RESULTS Most of the G-NECs tumor cells exhibited a near-uniform expression pattern of PD-L1, while some showed a tumor-stromal interface enhanced pattern. Of the 43G-NECs, 21(48.8%) were classified as a high PD-L1 expression group, and the high expression of PD-L1 was associated with poor overall survival(OS). The high expression of PD-L1 was correlated with abundant PD-1^+ tumor infiltrating lymphocytes(TILs) instead of CD8^+ TILs and FOXP3^+ regulatory T cells(Tregs).Our analysis also suggested that the infiltration of CD8^+ TILs tended to be a favorable factor for OS, although the difference did not reach the statistical significance(P = 0.065). Meanwhile, PD-L1 was significantly overexpressed in cases with copy number gain as compared with those without.CONCLUSION Our data demonstrated for the first time that high expression of PD-L1 in GNECs is associated with a poor prognosis, while the high expression may be due to the copy number variation of PD-L1 gene or stimulation of TILs. These results provide a basis for the immunotherapy targeting PD-1/PD-L1 pathway in GNECs. 展开更多
关键词 Programmed DEATH 1 Programmed DEATH LIGAND 1 gastric neuroendocrine carcinomaS Prognosis Tumor infiltrating LYMPHOCYTES
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Textbook Outcome as a measure of surgical quality assessment and prognosis in gastric neuroendocrine carcinoma:A large multicenter sample analysis 被引量:4
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作者 Qiyue Chen Zhongliang Ning +11 位作者 Zhiyu Liu Yanbing Zhou Qingliang He Yantao Tian Hankun Hao Wei Lin Lixin Jiang Gang Zhao Ping Li Chaohui Zheng Changming Huang on behalf of the Study Group for Gastric Neuroendocrine Tumors 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2021年第4期433-446,共14页
Objective:Quality assurance is crucial for oncological surgical treatment assessment.For rare diseases,singlequality indicators are not enough.We aim to develop a comprehensive and reproducible measurement,called the&... Objective:Quality assurance is crucial for oncological surgical treatment assessment.For rare diseases,singlequality indicators are not enough.We aim to develop a comprehensive and reproducible measurement,called the"Textbook Outcome"(TO),to assess the quality of surgical treatment and prognosis of gastric neuroendocrine carcinoma(G-NEC)patients.Methods:Data from patients with primary diagnosed G-NEC included in 24 high-volume Chinese hospitals from October 2005 to September 2018 were analyzed.TO included receiving a curative resection,≥15 lymph nodes examined,no severe postoperative complications,hospital stay≤21 d,and no hospital readmission≤30 d after discharge.Hospital variation in TO was analyzed using a case mix-adjusted funnel plot.Prognostic factors of survival and risk factors for non-Textbook Outcome(non-TO)were analyzed using Cox and logistic models,respectively.Results:TO was achieved in 56.6%of 860 G-NEC patients.TO patients had better overall survival(OS),disease-free survival(DFS),and recurrence-free survival(RFS)than non-TO patients(P<0.05).Moreover,TO patients accounted for 60.3%of patients without recurrence.Multivariate Cox analysis revealed non-TO as an independent risk factor for OS,DFS,and RFS of G-NEC patients(P<0.05).Increasing TO rates were associated with improved OS for G-NEC patients,but not hospital volume.Multivariate logistic regression revealed that nonlower tumors,open surgery,and>200 mL blood loss were independent risk factors for non-TO patients(P<0.05).Conclusions:TO is strongly associated with multicenter surgical quality and prognosis for G-NEC patients.Factors predicting non-TO are identified,which may help guide strategies to optimize G-NEC outcomes. 展开更多
关键词 Textbook Outcome gastric neuroendocrine carcinoma surgical quality PROGNOSIS risk factor
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Neuroendocrine carcinoma of the gastric stump:A case report and literature review 被引量:1
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作者 Fu-Hai Ma Li-Yan Xue +4 位作者 Ying-Tai Chen Yi-Bin Xie Yu-Xin Zhong Quan Xu Yan-Tao Tian 《World Journal of Gastroenterology》 SCIE CAS 2018年第4期543-548,共6页
We herein report a case of neuroendocrine carcinoma of the gastric stump found 47 years after Billroth II gastric resection for a benign gastric ulcer. A 74-yearold man was referred to another hospital with melena. En... We herein report a case of neuroendocrine carcinoma of the gastric stump found 47 years after Billroth II gastric resection for a benign gastric ulcer. A 74-yearold man was referred to another hospital with melena. Endoscopic examination revealed a localized ulcerative lesion at the gastrojejunal anastomosis. The diagnosis by endoscopic biopsy was neuroendocrine carcinoma. A total gastrectomy of the remnant stomach with D2 lymphadenectomy was performed at our hospital. The lesion invaded the subserosa, and metastasis was found in two of nine the lymph nodes retrieved. The lesion was positive for synaptophysin and chromogranin A, and the Ki-67 labeling index was 60%. The diagnosis of neuroendocrine carcinoma of the gastric stump was confirmed using World Health Organization 2010 criteria. Subsequently, the patient underwent one course of adjuvant chemotherapy with the etoposide plus cisplatin(EP) regimen; however, treatment was discontinued due to grade 3 myelosuppression. The patient showed lymph node metastasis in the region around the gastrojejunal anastomosis in the abdominal cavity 7 mo post-surgery. He then underwent radiotherapy and platinum-based combination chemotherapy; however, the disease progressed and liver recurrence was observed on follow-up computedtomography at 16 mo post-surgery. The patient then received chemotherapy with regimens used for the treatment of small cell lung cancer in first-and secondline settings. The patient died of disease progression 31 months after surgery. 展开更多
关键词 gastric stump gastric stump CANCER neuroendocrine carcinoma
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Mixed neuroendocrine carcinoma of the gastric stump: A case report
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作者 Hui Zhu Ming-Yuan Zhang +1 位作者 Wei-Liang Sun Gun Chen 《World Journal of Clinical Cases》 SCIE 2021年第27期8090-8096,共7页
BACKGROUND Gastric stump cancer,also known as gastric remnant cancer(GRC),is one of the main complications of postgastrectomy syndrome,which usually occurs following Billroth II reconstruction.The predominant histolog... BACKGROUND Gastric stump cancer,also known as gastric remnant cancer(GRC),is one of the main complications of postgastrectomy syndrome,which usually occurs following Billroth II reconstruction.The predominant histological subtype of GRC is adenocarcinoma,whereas neuroendocrine carcinoma is relatively rare.In particular,there are few recently reported cases of mixed neuroendocrine carcinoma(MNEC)in the English literature.Here,we present an extremely rare case of MNEC of the gastric stump.CASE SUMMARY A 59-year-old patient presented to our department owing to chronic constipation.He had undergone subtotal gastric resection 35 years prior to admission because of benign peptic ulcer.After admission,the patient underwent several tests,and gastroendoscopy showed evidence of Billroth II gastrectomy and local thickening of the gastric stump mucosa at the gastrojejunostomy site,with bile reflux;pathological biopsy revealed adenocarcinoma.He was then diagnosed with GRC and underwent total gastrectomy,D2 Lymphadenectomy,and esophagojejunal Roux-en-Y reconstruction.Histopathological examination of the specimen identified MNEC comprising MNEC(60%),adenocarcinoma(30%),and squamous cell carcinoma(10%).Postoperative adjuvant chemotherapy was initiated on September 17,2020.Taxol plus cisplatin was administered for only one cycle because of severe liver function damage,and the regimen was changed to etoposide plus cisplatin on October 10,2020 for five cycles.The patient recovered,with no recurrence after 6 mo of follow-up.CONCLUSION Gastric MNECs(GMNECs)is a rare type of GRC.This study presented the unusual occurrence of GMNEC in the gastric stump.This case will contribute to improvements in our understanding of the carcinogenesis,biology,pathology,and behavior of GMNEC and GRC. 展开更多
关键词 gastric remnant cancer gastric mixed neuroendocrine carcinoma SURGERY gastric stump Billroth II Case report
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Gastric Neuroendocrine Carcinoma in a Dog
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作者 Nadja Herbach Stefan Unterer Walter Hermanns 《Open Journal of Pathology》 2012年第4期162-165,共4页
A gastric biopsy specimen from a 14-year-old Yorkshire terrier was analysed using light microscopy, immunohistochemistry and transmission electron microscopy. The biopsies were obtained from a 3 × 3 × 4 cm m... A gastric biopsy specimen from a 14-year-old Yorkshire terrier was analysed using light microscopy, immunohistochemistry and transmission electron microscopy. The biopsies were obtained from a 3 × 3 × 4 cm mass located at the gastric cardia. Light microscopy revealed solid nests and sheets of tumour cells separated by abundant fibrovascular stroma in all gastric layers. The tumour cells were monomorphic, with eosinophilic cytoplasm and demonstrated palisading at the periphery. Nuclei were round to oval with densely packed chromatin and inconspicuous nucleoli. The tumour cells immunohistochemically stained strongly positive for chromogranin A, synaptophysin, and pan-cytokeratin. Electron microscopy revealed electron dense neurosecretory granules of 100 - 150 nm in diameter. Metastases were found in regional lymph nodes. Gastric neuroendocrine carcinoma was diagnosed, according to the histological, immunohistochemical and electron microscopic features. 展开更多
关键词 gastric CARCINOID gastric neuroendocrine carcinoma DOG STOMACH
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Oxyntic gland adenoma endoscopically mimicking a gastric neuroendocrine tumor: A case report 被引量:3
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作者 Tae-In Lee Jae-Young Jang +3 位作者 Seungmin Kim Jung-Wook Kim Young-Woon Chang Youn-Wha Kim 《World Journal of Gastroenterology》 SCIE CAS 2015年第16期5099-5104,共6页
Gastric adenocarcinoma is one of the most common malignancies worldwide.Histochemical and immunohistologic analyses classify the phenotypes of gastric adenocarcinoma into several groups based on the variable clinical ... Gastric adenocarcinoma is one of the most common malignancies worldwide.Histochemical and immunohistologic analyses classify the phenotypes of gastric adenocarcinoma into several groups based on the variable clinical and pathologic features.A new and rare variant of gastric adenocarcinoma with chief cell differentiation(GA-CCD)has recently been recognized.Studies reporting the distinct clinicopathologic characteristics proposed the term oxyntic gland polyp/adenoma because of the benign nature of the GACCD.Typically,GA-CCD is a solitary mucosal lesion that develops either in the gastric cardia or fundus.Histologically,this lesion is characterized by tightly clustered glands and anastomosing cords of chief cells.Immunohistochemically,GA-CCD is diffusely positive for mucin(MUC)6 and negative for MUC2and MUC5AC.However,other gastric tumors such as a gastric neuroendocrine tumor or fundic gland polyp have been difficult to exclude.Because GA-CCD tends to be endoscopically misdiagnosed as a neuroendocrine tumor or fundic gland polyp,comprehensive assessment and observation by an endoscopist are strongly recommended.Herein,we report a rare case of oxyntic gland adenoma endoscopically mimicking a gastric neuroendocrine tumor that was successfully removed by endoscopic mucosal resection. 展开更多
关键词 CHIEF cell differentiation gastric carcinoma MUCIN 6 neuroendocrine tumor Oxyntic GLAND ADENOMA
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Gastric neuroendocrine neoplasms: A review 被引量:2
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作者 Huseyin Koseoglu Tolga Duzenli Mesut Sezikli 《World Journal of Clinical Cases》 SCIE 2021年第27期7973-7985,共13页
Gastric neuroendocrine neoplasms(g-NENs)or neuroendocrine tumors are generally slow-growing tumors with increasing incidence.They arise from enterochromaffin like cells and are divided into four types according to cli... Gastric neuroendocrine neoplasms(g-NENs)or neuroendocrine tumors are generally slow-growing tumors with increasing incidence.They arise from enterochromaffin like cells and are divided into four types according to clinical characteristic features.Type 1 and 2 are gastrin dependent,whereas type 3 and 4 are sporadic.The reason for hypergastrinemia is atrophic gastritis in type 1,and gastrin releasing tumor(gastrinoma)in type 2 g-NEN.The diagnosis of g-NENs needs histopathological investigation taken by upper gastrointestinal endoscopy.g-NENs are positively stained with chomogranin A and synaptophysin.Grading is made with mitotic index and ki-67 proliferation index on histopathological analysis.It is crucial to discriminate between types of g-NENs,because the management,treatment and prognosis differ significantly between subtypes.Treatment options for g-NENs include endoscopic resection,surgical resection with or without antrectomy,medical treatment with somatostatin analogues,netazepide or chemotherapy regimens.Follow-up without excision is another option in appropriate cases.The prognosis of type 1 and 2 g-NENs are good,whereas the prognosis of type 3 and 4 g-NENs are close to the prognosis of gastric adenocancer. 展开更多
关键词 gastric neuroendocrine tumors gastric neuroendocrine neoplasm gastric neuroendocrine carcinoma HYPERGASTRINEMIA CARCINOID Somatostatin receptor imaging
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Mixed large and small cell neuroendocrine carcinoma of the stomach:A case report and review of literature 被引量:1
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作者 Ze-Feng Li Hai-Zhen Lu +4 位作者 Ying-Tai Chen Xiao-Feng Bai Tong-Bo Wang He Fei Dong-Bing Zhao 《World Journal of Clinical Cases》 SCIE 2022年第16期5502-5509,共8页
BACKGROUND Gastric neuroendocrine carcinoma(GNEC)is a rare histological subtype of gastric cancer,which is categorized into small cell and large cell neuroendocrine carcinomas.It is characterized by strong invasivenes... BACKGROUND Gastric neuroendocrine carcinoma(GNEC)is a rare histological subtype of gastric cancer,which is categorized into small cell and large cell neuroendocrine carcinomas.It is characterized by strong invasiveness and poor prognosis.Mixed large and small cell neuroendocrine carcinoma(L/SCNEC)is an extremely rare pathological type of gastric cancer,and there have been no reports on this situation until now.CASE SUMMARY Herein,we first present a 57-year-old patient diagnosed with L/SCNEC of the stomach.A 57-year-old Chinese male presented with epigastric discomfort.Outpatient gastroscopic biopsy was performed,and pathological examination revealed that the cardia was invaded by adenocarcinoma.The patient underwent laparoscopic-assisted radical proximal subtotal gastrectomy and was diagnosed with L/SCNEC.He refused adjuvant treatment and was followed up every 3 mo.Eight months after the operation,the patient showed no evidence of local recurrence or distant metastasis.CONCLUSION We advocate conducting further genomic studies to explore the origin of gastric large cell and small cell neuroendocrine carcinoma and using different chemotherapy schemes according to large or small cell neuroendocrine carcinoma of the stomach for clinical research to clarify the heterogeneity of GNEC and improve the prognosis of patients with GNEC. 展开更多
关键词 gastric cancer neuroendocrine carcinoma SUBTYPES TUMORIGENESIS TREATMENTS Case report
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胃神经内分泌癌的研究进展
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作者 周凯 王安强 +2 位作者 吴艳 李忠武 步召德 《中国肿瘤临床》 CAS CSCD 北大核心 2024年第2期81-85,共5页
胃神经内分泌癌(gastric neuroendocrine carcinoma,G-NEC)发病率极低。患者确诊时多数已处于晚期,且通常比胃腺癌更具侵袭性,更易发生脉管癌栓、神经侵犯及术后肝转移。目前治疗方法有限且尚未形成统一的规范化方案,导致患者预后较差... 胃神经内分泌癌(gastric neuroendocrine carcinoma,G-NEC)发病率极低。患者确诊时多数已处于晚期,且通常比胃腺癌更具侵袭性,更易发生脉管癌栓、神经侵犯及术后肝转移。目前治疗方法有限且尚未形成统一的规范化方案,导致患者预后较差。随着人类G-NEC的基因组图谱的构建,识别出MYC作为疾病的关键驱动因子,开发小鼠模型来研究其分子和细胞特征,通过大规模的遗传和药理筛选,为理解G-NEC的生物学特性及治疗提供了新的思路。目前对于G-NEC的发病机制、分子生物学特征、临床病理特点及诊治仍缺乏足够的认识,为进一步提升对该疾病的系统认知,本文对国内外文献进行系统总结,旨在为G-NEC的大样本临床基础转化研究提供系统的理论支持。 展开更多
关键词 胃神经内分泌癌 发病机制 分子生物学特征 诊疗
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Importance of gastrin in the pathogenesis and treatment of gastric tumors 被引量:36
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作者 Michael D Burkitt Andrea Varro D Mark Pritchard 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第1期1-16,共16页
In addition to regulating acid secretion, the gastric antral hormone gastrin regulates several important cellular processes in the gastric epithelium including proliferation, apoptosis, migration, invasion, tissue rem... In addition to regulating acid secretion, the gastric antral hormone gastrin regulates several important cellular processes in the gastric epithelium including proliferation, apoptosis, migration, invasion, tissue remodelling and angiogenesis. Elevated serum concentrations of this hormone are caused by many conditions, particularly hypochlorhydria (as a result of autoimmune or Helicobacter pylori (H pylori)-induced chronic atrophic gastritis or acid suppressing drugs) and gastrin producing tumors (gastrinomas). There is now accumulating evidence that altered local and plasma concentrations of gastrin may play a role during the development of various gastric tumors. In the absence of H pylori infection, marked hypergastrinemia frequently results in the development of gastric enterochromaffi n cell-like neuroendocrine tumors and surgery to remove the cause of hypergastrinemia may lead to tumor resolution in this condition. In animal models such as transgenic INS-GAS mice, hypergastrinemia has also been shown to act as a cofactor with Helicobacter infection during gastric adenocarcinoma development. However, it is currently unclear as to what extent gastrin also modulates human gastric adenocarcinoma development. Therapeutic approaches targeting hypergastrinemia,such as immunization with G17DT, have been evaluated for the treatment of gastric adenocarcinoma, with some promising results. Although the mild hypergastrinemia associated with proton pump inhibitor drug use has been shown to cause ECL-cell hyperplasia and to increase H pylori-induced gastric atrophy, there is currently no convincing evidence that this class of agents contributes towards the development of gastric neuroendocrine tumors or gastric adenocarcinomas in human subjects. 展开更多
关键词 Helicobacter py/ori HYPERGASTRINEMIA neuroendocrine gastric carcinoma Proton pumpinhibitor
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不同类型胃恶性神经内分泌肿瘤与胃腺癌的临床病理特征和生存情况比较 被引量:1
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作者 张奔龙 高云鹤 +6 位作者 鲁意迅 李力 梁文全 郗洪庆 王鑫鑫 张珂诚 陈凛 《解放军医学院学报》 CAS 北大核心 2023年第4期324-332,共9页
背景胃恶性神经内分泌肿瘤包括胃神经内分泌癌和含有神经内分泌癌成分的混合性神经内分泌-非神经内分泌肿瘤,混合性神经内分泌-非神经内分泌肿瘤绝大多数为腺-神经内分泌癌,因其罕见性,目前缺乏系统性的研究提高对其临床病理特征及预后... 背景胃恶性神经内分泌肿瘤包括胃神经内分泌癌和含有神经内分泌癌成分的混合性神经内分泌-非神经内分泌肿瘤,混合性神经内分泌-非神经内分泌肿瘤绝大多数为腺-神经内分泌癌,因其罕见性,目前缺乏系统性的研究提高对其临床病理特征及预后的认识。目的以胃腺癌为参照,探究胃恶性神经内分泌肿瘤的临床病理特征和生存情况。方法采用回顾性病例对照研究的方法,收集2008年1月-2018年12月在解放军总医院第一医学中心行手术治疗的非cM1期胃恶性神经内分泌肿瘤及胃腺癌患者资料,分析、比较其临床病理特征。1:3倾向性评分匹配(PSM)调整胃恶性神经内分泌肿瘤和胃腺癌队列之间的混杂因素。Kaplan-Meier法绘制生存曲线,log-rank检验分析组间总生存率的差异,Cox回归模型分析患者预后的独立关联因素。结果共纳入5443例(96.0%)胃腺癌与226例(4.0%)胃恶性神经内分泌肿瘤,后者包括148例神经内分泌癌和78例腺-神经内分泌癌。胃恶性神经内分泌肿瘤与胃腺癌首诊年龄、性别、肿瘤大小、肿瘤部位、手术方法、胃切除方式、T分期、N分期、TNM分期的差异有统计学意义(P<0.05)。2875例胃腺癌和215例胃恶性神经内分泌肿瘤有完整的生存信息,倾向性匹配后进行生存分析,发现胃腺癌患者的总生存率显著优于胃恶性神经内分泌肿瘤患者(3年、5年生存率:67.3%vs 58.9%,59.8%vs 48.3%,P=0.002),亚组分析显示,胃腺癌患者的总生存率优于神经内分泌癌和腺-神经内分泌癌患者(3年、5年生存率:67.3%vs 57.5%和61.1%,59.8%vs 50.5%和44.9%,P均<0.05),但神经内分泌癌患者与腺-神经内分泌癌患者的总生存率无统计学差异(P=0.993)。对胃恶性神经内分泌肿瘤的分析显示,神经内分泌癌与腺-神经内分泌癌在首诊年龄、性别、肿瘤大小、肿瘤部位、手术方法、胃切除方式、T分期、N分期、TNM分期、免疫标记物表达上无统计学差异(P<0.05)。生存分析结果表明年龄(HR=1.945,95%CI:1.249~3.030)、肿瘤大小(HR=2.199,95%CI:1.029~4.701)、TNM分期[Ⅱ期vsⅠ期(HR=1.669,95%CI:0.596~4.670),Ⅲ期vsⅠ期(HR=5.710,95%CI:2.197~14.837)]与胃恶性神经内分泌肿瘤患者生存独立关联。结论胃恶性神经内分泌肿瘤与胃腺癌有着截然不同的临床病理特征,胃恶性神经内分泌肿瘤浸润能力更强,侵袭性更高,总生存率显著劣于胃腺癌,神经内分泌癌和腺-神经内分泌癌有着相似的临床病理特征及总生存率;年龄≥60岁、肿瘤≥3 cm、Ⅲ期多提示胃恶性神经内分泌肿瘤患者较差的预后。 展开更多
关键词 神经内分泌癌 腺癌 总体生存率 倾向性评分匹配
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胃癌中神经内分泌细胞的临床病理学意义 被引量:6
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作者 刘俊茹 魏守礼 +4 位作者 高国栋 陈秀鉴 焦炳忠 王凤荣 刘庆银 《肿瘤防治研究》 CAS CSCD 北大核心 1996年第6期347-349,共3页
本文应用铬粒素A(CgA)、胃泌素(GAS)、生长抑素(SS)及5-羟色胺(5-HT)对120例普通型胃癌用免疫组化SP法标记其神经内分泌细胞。结果表明:四种激素抗体检测,以CgA最敏感、阳性率最高为31.7%;高分... 本文应用铬粒素A(CgA)、胃泌素(GAS)、生长抑素(SS)及5-羟色胺(5-HT)对120例普通型胃癌用免疫组化SP法标记其神经内分泌细胞。结果表明:四种激素抗体检测,以CgA最敏感、阳性率最高为31.7%;高分化腺癌CgA阳性率显著高于低分化和未分化癌(P<0.05),但高分化腺癌CgA阳性病例以(+)为主,未分化癌以(++)为主;而SS.5HT的阳性率,高、低分化腺癌均高于未分化癌(P>0.05)。CgA及5-HT阳性病例淋巴结转移率高于阴性病例(P<0.05),CgA(++)病例术后生存期明显短于CgA(+)及CgA(-)者(P<0.05),GAS、5-HT及SS阳性与阴性病例术后生存期无显著差异。 展开更多
关键词 胃癌 神经 内分泌 免疫组化 病理学
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正常胃、癌旁胃、胃癌组织中神经内分泌细胞的超微结构形态诊断及意义 被引量:4
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作者 王鲁平 梁延杰 +1 位作者 虞积耀 史景泉 《电子显微学报》 CAS CSCD 1999年第3期307-313,共7页
本文应用透射电镜技术对9例正常胃粘膜,20例新鲜手术切除胃癌及癌旁粘膜的神经内分泌(NE)细胞进行观察,并与9种激素抗体免疫组化结果进行对比观察。电镜下正常胃泌酸区(体底)粘膜可见ECL细胞、P细胞、EC细胞,X细胞... 本文应用透射电镜技术对9例正常胃粘膜,20例新鲜手术切除胃癌及癌旁粘膜的神经内分泌(NE)细胞进行观察,并与9种激素抗体免疫组化结果进行对比观察。电镜下正常胃泌酸区(体底)粘膜可见ECL细胞、P细胞、EC细胞,X细胞、偶见D细胞;胃窦粘膜可见G细胞、D细胞,EC细胞。20例胃癌中含NE型癌细胞8例,依据NE颗粒的形态不同可分为三种类型。16例癌旁粘膜NE细胞的形态与正常相似,但数量有明显变化。对正常胃粘膜NE细胞的超微形态与功能,胃癌中NE细胞超微诊断特点及临床病理意义进行了探讨。 展开更多
关键词 胃癌 胃粘膜 内分泌细胞 透射电镜 超微结构
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胃癌中神经内分泌细胞形态特征及增殖活性的研究 被引量:4
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作者 王鲁平 史景泉 +2 位作者 梁延杰 虞积耀 丁华野 《临床与实验病理学杂志》 CAS CSCD 北大核心 1995年第4期261-264,共4页
应用双重免疫组化、图象分析及电镜技术对56例胃癌的神经内分泌(NE)细胞形态特征及增殖活性进行研究。结果发现胃癌中NE细胞有明显异型性及侵袭性。细胞形态图象测量显示NE阳性胃癌细胞和正常胃粘膜NE细胞在各参数的比较中... 应用双重免疫组化、图象分析及电镜技术对56例胃癌的神经内分泌(NE)细胞形态特征及增殖活性进行研究。结果发现胃癌中NE细胞有明显异型性及侵袭性。细胞形态图象测量显示NE阳性胃癌细胞和正常胃粘膜NE细胞在各参数的比较中差异均有高度显著性(P<0.01);但NE阳性胃癌细胞与NE阴性胃癌细胞各参数比较(除浆面积以外)差异均无显著性(P>0.05)。CgA/PCNA双重免疫组化结果显示:CgA阳性胃癌细胞PCNA同步标记率0~3%;CgA阴性胃癌细胞PCNA阳性标记率为31.9%±14.7%。上述结果提示:胃癌中NE细胞在形态学上与其它癌细胞一样,具有恶性肿瘤形态学特征,但这些细胞仅少数处于S期及G1期,绝大多数处于G0期,推测这些处于静止状态不伴DNA复制的细胞在某些生物活性肽的刺激下,可重新进入细胞周期进行DNA复制,完成细胞的增殖分裂。 展开更多
关键词 胃癌 神经内分泌细胞 形态特征 增殖
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胃神经内分泌癌的临床病理特征及预后因素 被引量:2
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作者 徐海燕 张志影 +2 位作者 任芳 唐雷 张凤春 《世界华人消化杂志》 CAS 北大核心 2014年第22期3291-3299,共9页
目的:探讨胃神经内分泌癌(gastric neuroendocrine carcinoma,GNEC)的临床病理特征及影响预后因素.方法:回顾性分析2007-11-01/2014-03-31上海交通大学医学院附属仁济医院及上海交通大学医学院附属九龙医院收治的50例胃神经内分泌癌患... 目的:探讨胃神经内分泌癌(gastric neuroendocrine carcinoma,GNEC)的临床病理特征及影响预后因素.方法:回顾性分析2007-11-01/2014-03-31上海交通大学医学院附属仁济医院及上海交通大学医学院附属九龙医院收治的50例胃神经内分泌癌患者的临床病理特征、治疗及生存资料.采用Kaplan-Meier法绘制生存曲线,Logrank检验法进行单因素分析,Cox比例风险回归模型进行多因素分析.结果:全组胃神经内分泌癌44例(G3级)、胃混合型腺神经内分泌癌(G2-3级)6例.男39例,女11例;平均年龄61.32岁±10.48岁.其中,Ⅱ期6例(12.0%),Ⅲ期患者34例(68.0%),Ⅳ期患者10例(20.0%).全部患者接受根治性胃及转移病灶切除手术治疗,其中34例存在淋巴结转移,17例存在血管、神经或淋巴管浸润.25例接受术后化疗,占50.0%;随访时间1-50 mo,15例患者复发,18例死亡.患者中位生存时间30.18mo±3.50 mo(95%CI:23.31-37.04 mo).单因素分析结果显示:患者中性粒细胞淋巴细胞比率(ratio of neutrophils to lymphocytes,NLR)、Ki67及化疗与否是影响GNEC患者预后的因素(P<0.05).多因素分析结果显示:Ki67是影响GNEC患者预后的独立因素(P<0.05).结论:GNEC相对罕见并恶性程度高,Ki67水平是影响患者预后的独立因素. 展开更多
关键词 神经内分泌癌 预后
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胃癌中神经内分泌细胞的临床病理意义 被引量:2
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作者 王鲁平 史景泉 +1 位作者 梁延杰 虞积耀 《解放军医学杂志》 CAS CSCD 北大核心 1995年第2期98-101,共4页
应用组织学,免疫组化,透射电镜对189例各组织学类型胃癌的神经内分泌(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,所采用的9种激素... 应用组织学,免疫组化,透射电镜对189例各组织学类型胃癌的神经内分泌(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,所采用的9种激素抗体在胃癌组织中均有阳性表达。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。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(68.42%),明显高于其他激素的阳性表达(10%~31.6%,P<0.001)。胃癌中产生某些激素与患者存活期有关。上述结果提示:胃癌中某些NE细胞分泌的激素产物可能对胃癌浸润转移及预后有较重要的影响。 展开更多
关键词 胃肿瘤 神经内分泌细胞 电镜 免疫组织化学
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胃癌及癌旁组织中神经内分泌细胞的超微结构与免疫组化诊断及其意义 被引量:2
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作者 王鲁平 梁延杰 +2 位作者 虞积耀 史景泉 丁华野 《诊断病理学杂志》 CSCD 1995年第2期76-78,共3页
本文应用透射电镜技术对20例新鲜手术切除胃癌及癌旁粘膜、4例正常胃粘膜的神经内分泌(NE)细胞进行观察,并与抗CgA抗体及9种激素抗体免疫组化技术进行对比观察。电镜下正常胃泌酸区粘膜可见ECL细胞、P细胞、EC细胞、... 本文应用透射电镜技术对20例新鲜手术切除胃癌及癌旁粘膜、4例正常胃粘膜的神经内分泌(NE)细胞进行观察,并与抗CgA抗体及9种激素抗体免疫组化技术进行对比观察。电镜下正常胃泌酸区粘膜可见ECL细胞、P细胞、EC细胞、X细胞,偶见D细胞;胃窦粘膜可见G细胞、D细胞、EC细胞。20例胃癌中含NE型癌细胞8例,依据内分泌颗粒的形态不同可分为三种类型。16例癌旁粘膜NE细胞的形态与正常相似,但数量有明显变化。对正常胃粘膜NE细胞的超微形态与功能,胃癌中NE细胞超微诊断特点及临床病理意义进行了探讨。 展开更多
关键词 胃癌 内分泌细胞 透射电镜 免疫组化 诊断
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10例胃小细胞型神经内分泌癌的临床病理分析 被引量:2
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作者 姚娟 苑红梅 +3 位作者 赵红梅 李萍 贾苏建 杨桂珍 《临床肿瘤学杂志》 CAS 2016年第4期357-360,共4页
目的观察胃小细胞型神经内分泌癌(SCNEC-G)的临床病理特点,探讨其诊断及鉴别诊断要点,提高其病理诊断准确性,为其综合治疗提供依据。方法对2010年至2015年10例SCNEC-G根治手术标本的组织切片行光镜观察,经免疫组织化学标记,分析突触素(S... 目的观察胃小细胞型神经内分泌癌(SCNEC-G)的临床病理特点,探讨其诊断及鉴别诊断要点,提高其病理诊断准确性,为其综合治疗提供依据。方法对2010年至2015年10例SCNEC-G根治手术标本的组织切片行光镜观察,经免疫组织化学标记,分析突触素(Syn)、嗜铬蛋白A(CgA)、神经细胞黏附分子(CD56)、甲状腺转录因子-1(TTF-1)蛋白和Ki-67的表达情况。结果 SCNEC-G呈浸润性生长,癌细胞呈弥漫、大小不等巢团状、条梭状排列,部分病例局灶可呈假腺样结构,肿瘤表面及肿瘤内部均可见核碎屑和凝固性坏死,癌细胞小,呈圆形、卵圆形、短梭形,核深染,核仁不明显,可见较多核分裂。10例癌组织浸润深度为胃壁深肌层至全层,部分病例浸润至胃壁周围脂肪组织,所有样本均有神经侵犯和脉管内癌栓。10例SCNEC-G患者中,Syn、CgA、CD56、TTF-1、Ki-67阳性至强阳性表达率分别为80.0%、70.0%、80.0%、40.0%和100.0%。结论 SCNEC-G对神经源性抗原敏感性较高,同时部分病例TTF-1阳性表达,在原发灶不明的TTF-1阳性转移性小细胞癌中,仍需考虑SCNEC-G的可能。 展开更多
关键词 胃癌 神经内分泌癌 小细胞癌 免疫组织化学 甲状腺转录因子-1(TTF-1)
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原位免疫PCR技术及对胃癌神经内分泌分化的研究 被引量:3
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作者 董葆 虞积耀 +3 位作者 张波 郑集义 张秀荣 吴秉铨 《诊断病理学杂志》 CSCD 1995年第3期155-156,共2页
原位免疫PCR技术是将合成生物素标记的外源性DNA片段通过卵白素与生物素标记抗体结合,进行原位PCR反应,使外源性DNA片段作为放大信号,再应用免疫组化ABC法显示信号。本文应用原位免疫PCR技术及免疫组化方法对22... 原位免疫PCR技术是将合成生物素标记的外源性DNA片段通过卵白素与生物素标记抗体结合,进行原位PCR反应,使外源性DNA片段作为放大信号,再应用免疫组化ABC法显示信号。本文应用原位免疫PCR技术及免疫组化方法对22例胃癌的嗜铬粒蛋白A(CgA)进行观察,结果发现免疫组化CgA阳性率为38.6%,原位免疫PCR为85.7%,证明胃癌中含有神经内分泌细胞是很常见的现象。本文对原位免疫PCR技术进行了介绍和讨论。 展开更多
关键词 原位免疫PCR 胃癌 神经内分泌细胞
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