食管癌伴神经内分泌分化的临床病理特点及诊断标志物

doi:10.6040/j.issn.1671-7554.0.2015.138

摘要/Abstract

摘要： 目的探讨食管癌伴神经内分泌分化(E-NED)的临床病理特点及诊断标志物。方法回顾性分析 2008年1月至2013年12月经病理证实的低分化食管癌378例患者的临床病理资料, 其中无NED(E-NNED)349例, E-NED 29例, 免疫组织化学检测29例E-NED以及随机选取20例E-NNED患者肿瘤组织中突触素(Syn)、嗜铬蛋白A(CgA)、神经元特异性烯醇化酶(NSE)、神经细胞黏附分子(CD56)、蛋白基因产物9.5(PGP9.5)、促泌素(SCGN)、甲状腺转录因子1(TTF-1)的表达。结果 E-NED与E-NNED患者的年龄、性别、病变长度等临床病理因素差异均无统计学意义(P>0.05)。除TTF-1外, E-NED患者的Syn、CgA、NSE、CD56、PGP9.5及SCGN表达均高于E-NNED患者(P<0.05)。在联合检测中, Syn分别与CD56、PGP9.5或SCGN构成的3种组合敏感性、阳性预测值及诊断正确率均高于Syn+CgA组合(P<0.05)。E-NED与E-NNED患者的1、2、3年生存率差异无统计学意义(P>0.05)。结论 E-NED与E-NNED可能是不同的食管癌病理类型, PGP9.5、SCGN均可作为E-NED的诊断标志物, Syn与CD56、PGP9.5或SCGN联合检测可提高诊断敏感性和正确率。

关键词: 突触素, 食管癌, 神经内分泌分化, 预后, 神经细胞黏附分子, 蛋白基因产物9.5, 促泌素

Abstract: Objective To investigate the clinico-pathological characteristics and diagnostic markers in esophageal carcinoma accompanied by neuroendocrine cell differentiation (E-NED). Methods The clinico-pathological data of 378 patients with poorly differentiated esophageal carcinoma from Jan. 2008 to Dec. 2013, including 349 without neuroendocrine differentiation (E-NNED) and 29 with neuroendocrine differentiation (E-NED), were retrospectively analyzed. The expressions of synaptophysin (SYN), chromogranin A (CgA), neuron-specific enolase (NSE), neural cell adhesion molecule (CD56), protein gene product (PGP9.5), secretagogin (SCGN) and thyroid transcription factor 1 (TTF-1) in the esophageal carcinoma tissues of 29 patients with E-NED and 20 ones randomly selected from the 349 patients with E-NNED were detected using immunohistochemistry. Results There were no significant differences between the patients with E-NED and E-NNED in terms of the age, gender, length of lesion and other clinico-pathological factors. Except for TTF-1, the expressions of Syn, CgA, NSE, CD56, PGP9.5 and SCGN were significantly higher in patients with E-NED than those with E-NNED (P<0.05). The sensitivity, positive predictive value anddiagnostic accuracy were all higher in the combined detection of Syn and CD56, PGP9.5 or SCGN than Syn and CgA (P<0.05). There were no significant differences between the patients with E-NED and E-NNED regarding 1, 2 and 3-year survival rates. Conclusion E-NED and E-NNED may be different pathological types of esophageal carcinoma. Both PGP9.5 and SCGN can be considered as the diagnostic markers of E-NED, and the combined detection of Syn and CD56, PGP9.5 or SCGN can improve the sensitivity and diagnostic accuracy.

Key words: Esophageal carcinoma, Neuroendocrine cell differentiation, Secretagogin, Prognosis, Synaptophysin, Neural cell adhesion molecule, Protein gene product 9.5

中图分类号:

R735.1

刘连科, 邵明雯, 马兰, 孙婧, 管丹, 束永前. 食管癌伴神经内分泌分化的临床病理特点及诊断标志物[J]. 山东大学学报（医学版）, 2015, 53(7): 87-91.

LIU Lianke, SHAO Mingwen, MA Lan, SUN Jing, GUAN Dan, SHU Yongqian. Clinico-pathological characteristics and diagnostic biomarkers in patients with esophageal carcinoma accompanied by neuroendocrine cell differentiation[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2015, 53(7): 87-91.

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