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目的分析消化道混合性腺神经内分泌癌的病理形态特征,探讨其诊断要点。方法对确诊为混合性腺神经内分泌癌的消化道手术切除标本9例进行光镜观察和突触素(Syn)、嗜铬粒蛋白(CgA)、癌胚抗原(CEA),细胞角蛋白8/18(CK8/18),Ki-67等5种抗体免疫组织化学染色,并复习其临床资料.结果镜下可见具有腺癌特征和神经内分泌肿瘤特征的两种区域,各种标志物的免疫组化染色阳性比率:CEA及CK8/18全部阳性(9/9,100%),Syn阳性6例(6/9,66.7%),CgA阳性5例(5/9,55.6%)。结论消化道混合性腺神经内分泌癌临床上比较少见,形态学上与常见的低分化腺癌不易区分,需要依靠免疫组化检测进行区分,其预后较一般腺癌差。
Objective To analyze the pathological features of gastrointestinal mixed glandular neuroendocrine carcinoma and to discuss the main points of diagnosis. Methods Nine cases of resected specimens of gastrointestinal tract diagnosed as mixed glandular neuroendocrine carcinoma were observed with light microscopy and immunohistochemical staining for synaptophysin (Syn), chromogranin (CgA), carcinoembryonic antigen (CEA), cytokeratin 8/18 (CK8 / 18), Ki-67 and other five kinds of antibody immunohistochemical staining, and review the clinical data.Results There are two types of adenocarcinoma and neuroendocrine tumor features of the microscope, immunohistochemistry of various markers The positive rates of staining were CEA and CK8 / 18 (9/9, 100%), Syn was 6 cases (6/9, 66.7%), and CgA was 5 cases (5/9, 55.6%). Conclusions Gastrointestinal mixed glandular neuroendocrine carcinoma is relatively rare in clinical practice. It is not easy to distinguish the differentiated adenocarcinomas from the common ones in morphology, which needs to be distinguished by immunohistochemical detection. Its prognosis is poorer than that of adenocarcinoma.