您的位置：山东大学 -> 科技期刊社 -> 《山东大学学报（医学版）》

山东大学学报（医学版） ›› 2015, Vol. 53 ›› Issue (7): 87-91.doi: 10.6040/j.issn.1671-7554.0.2015.138

• 临床医学 • 上一篇    下一篇

食管癌伴神经内分泌分化的临床病理特点及诊断标志物

刘连科1, 邵明雯2, 马兰1, 孙婧1, 管丹1, 束永前1   

  1. 1. 南京医科大学第一附属医院肿瘤科, 江苏 南京 210029;
    2. 武警江苏省总队医院内科, 江苏 扬州 225003
  • 收稿日期:2015-02-03 修回日期:2015-05-20 发布日期:2015-07-10
  • 通讯作者: 刘连科。E-mail:liulianke@csco.org.cn E-mail:liulianke@csco.org.cn
  • 基金资助:
    江苏省高校优势学科建设工程资助项目(JX10231801);中国高校医学期刊临床专项资金(11520112)

Clinico-pathological characteristics and diagnostic biomarkers in patients with esophageal carcinoma accompanied by neuroendocrine cell differentiation

LIU Lianke1, SHAO Mingwen2, MA Lan1, SUN Jing1, GUAN Dan1, SHU Yongqian1   

  1. 1. Department of Oncology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China;
    2. Department of Internal Medicine, Jiangsu Armed Police General Hospital, Yangzhou 225003, Jiangsu, China
  • Received:2015-02-03 Revised:2015-05-20 Published:2015-07-10

PDF (PC)

443

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
[1] 汪慧访, 武爱文, 袁鹏, 等. 具有神经内分泌特征胃癌的诊治及预后分析[J]. 中华胃肠外科杂志, 2011, 14(2): 96-99. WANG Huifang, WU Aiwen, YUAN Peng, et al. Gastric neuroendocrine carcinoma and gastric carcinoma with neuroendocrine cell differentiation: a clinical and prognostic analysis[J]. Chin J Gastrointest Surg, 2011, 14(2): 96-99.
[2] Schartinger VH, Falkeis C, Laimer K, et al. Neuroendocrine differentiation in head and neck squamous cell carcinoma[J]. J Laryngol Otol, 2012, 126(12):1261-1270.
[3] 杜芸, 王永军, 杨会钗, 等. 食管早期鳞癌的神经内分泌分化及其意义[J]. 癌变·畸变·突变, 2006, 18(6): 459-461. DU Yun, WANG Yongjun, YANG Huichai, et al. Neuroendocrine differentiation and its significance in early esophageal squamous cell carcinoma[J]. Carcino Genesis, Terato Genesis & Mutagenesis, 2006, 18(6): 459-461.
[4] Yuan A , Liu J, Liu Y, et al. Chromogranin A-positive tumor cells in human esophageal squamous cell carcinomas[J]. Pathol Oncol Res, 2007, 13(4): 321-325.
[5] Bartley AN, Rashid A, Fournier KF, et al. Neuroendocrine and mucinous differentiation in signet ring cell carcinoma of the stomach: evidence for a common cell of origin in composite tumors[J]. Hum Pathol, 2011, 42(10): 1420-1429.
[6] Segawa Y, Takata S, Fujii M, et al. Immunohistochemical detection of neuroendocrine differentiation in non-small-cell lung cancer and its clinical implications[J]. J Cancer Res Clin Oncol, 2009, 135(8):1055-1059.
[7] 2013年中国胃肠胰神经内分泌肿瘤病理诊断共识专家组. 中国胃肠胰神经内分泌肿瘤病理诊断共识(2013版)[J]. 中华病理学杂志, 2013, 42(10): 691-694. 2013 Chinese Pathological Diagnostic Consensus Expert Group of Gastrointestinal and Pancreatic Neuroendocrine Tumor. Consensus of pathological diagnosis for Chinese gastrointestinal and pancreatic neuroendocrine[J]. Chinese J Pathol, 2013, 42(10): 691-694.
[8] 李景南, 张红杰, 陈洁, 等. 胃肠胰神经内分泌肿瘤内科诊治若干建议[J]. 中华消化杂志, 2014, 34(6): 361-367.
[9] 盛伟琪.胃肠胰神经内分泌肿瘤病理诊断的规范和进展[J]. 中国癌症杂志, 2013, 23(6) : 401-407. SHENG Weiqi. Advances and pathological diagnostic standard of gastroenteropancreatic neuroendocrine neoplasms[J]. China Oncology, 2013, 23(6):401-407.
[10] Stotz M, Eisner F, Szkandera J, et al. Clinico-pathological characteristics and clinical outcome of different histological types of pancreatic cancer in a large Middle European series[J]. J Clin Pathol, 2013, 66(9):753-757.
[11] 于红梅, 刘晓文, 龙子雯, 等. 胃癌伴神经内分泌分化的临床病理及预后分析[J]. 中国癌症杂志, 2013, 23(1): 42-46. YU Hongmei, LIU Xiaowen, LONG Ziwen, et al. Analysis of clinicopathological features and prognosis of gastric cancer with neuroendocrine cell differentiation[J]. China Oncology, 2013, 23(1): 42-46.
[12] Cho YB, Yang SS, Lee WY, et al. The clinical significance of neuroendocrine differentiation in T3-T4 node-negative colorectal cancer[J]. Int J Surg Pathol, 2010, 18(3): 201-206.
[13] 张军, 郑锴, 郭燕, 等. 非小细胞肺癌神经内分泌分化与其生物学特性及预后关系的研究[J]. 中国肺癌杂志, 2010, 13(9): 873-876. ZHANG Jun, ZHENG Kai, GUO Yan, et al. Research on the relationship between non-small cell lung cancer with neuroendocrine differentiation and the biological characteristics and prognosis[J]. Chin J Lung Cancer, 2010, 13(9): 873-876.
[14] Gottschling S, Jensen K, Herth FJ, et al. Lack of prognostic significance of neuroendocrine differentiation and stem cell antigen co-expression in resected early-stage non-small cell lung cancer[J]. Anticancer Res, 2013, 33(3): 981-990.
[15] Tian Z, Wei B, Tang F, et al. Prognostic significance of tumor grading and staging in mammary carcinomas with neuroendocrine differentiation[J]. Hum Pathol, 2011, 42(8): 1169-1177.
[16] Sawaki M, Yokoi K, Nagasaka T, et al. Prognostic importance of neuroendocrine differentiation in Japanese breast cancer patients[J]. Surg Today, 2010, 40(9): 831-835.
[1] 李梓绮,魏闫若雪,刘晓晗,刘春铖,赵然,刘玉昆. 长链非编码RNA HEATR3反义RNA 1参与结直肠癌发生发展的功能及其临床意义[J]. 山东大学学报 (医学版), 2025, 63(9): 108-115.
[2] 刘保国,宋翔,赵晓文,毛亚丽. 血清STAT5B、NKAIN1 mRNA检测在乳腺癌中的应用价值[J]. 山东大学学报 (医学版), 2025, 63(7): 68-74.
[3] 王磊,常霄,王梓萌,李娇娇,崔书君,杨飞,朱月香. 瘤内及瘤周DCE-MRI影像组学对宫颈癌患者无进展生存期的预测价值[J]. 山东大学学报 (医学版), 2025, 63(6): 45-54.
[4] 贾若曦,吕丽,刘涵云,吴寅平,李凤彩,赵泽华,王凯,范玉琛. 血细胞计数相关标志物对慢加急性乙型肝炎肝衰竭患者28天预后的诊断价值[J]. 山东大学学报 (医学版), 2025, 63(6): 89-99.
[5] 杜雪,李春霞,刘云霞,张涛. 基于MFPC-Cox的结直肠癌患者预后动态预测模型[J]. 山东大学学报 (医学版), 2025, 63(5): 101-110.
[6] 杨卫芳,徐宏,刘元涛,赵蕙琛. 促甲状腺激素受体抗体在Graves病复发中的作用机制及其临床意义[J]. 山东大学学报 (医学版), 2025, 63(4): 116-121.
[7] 刘文钊,张远,马湘萍,魏峰涛,卜培莉. 内皮活化和应激指数预测值与心力衰竭患者死亡风险的关联[J]. 山东大学学报 (医学版), 2025, 63(11): 27-35.
[8] 陈文亮,王欢欢,郝金锦,弓蕊,赵强,张飞,高磊,董静逊. lncRNA PVT1表达在胃癌预后评估及恶性进展中的作用:基于列线图模型与细胞功能实验的研究[J]. 山东大学学报 (医学版), 2025, 63(10): 61-71.
[9] 郭姝画,樊扬,田风,王传新,杜鲁涛,李培龙,郭兴,徐硕. 微原纤维相关蛋白3在调控胶质瘤干细胞间充质表型转化中的作用[J]. 山东大学学报 (医学版), 2024, 62(6): 9-16.
[10] 魏闫若雪,李梓绮,刘春铖,刘晓晗,赵然,刘玉昆. 结直肠癌中SP1的瘤内异质性表达及其临床意义[J]. 山东大学学报 (医学版), 2024, 62(5): 89-94.
[11] 刘春铖,刘晓晗,魏闫若雪,李梓绮,刘玉昆,赵然. 结直肠癌中含溴结构域蛋白9的亚细胞定位模式及其临床意义[J]. 山东大学学报 (医学版), 2024, 62(4): 24-30.
[12] 杨雪彦,吴寅平,吕丽,赵泽华,马行宇,李凤彩,王凯,范玉琛. 单核细胞与淋巴细胞比值动态变化对慢加急性乙型肝炎肝衰竭预后的诊断价值[J]. 山东大学学报 (医学版), 2024, 62(3): 61-69.
[13] 刁玉洁,林琳,李文瑄,王洲洋,江蓓,胡迎迎,刘广义. NPR预测ANCA相关血管炎不良肾脏预后及其协同多因素优化模型[J]. 山东大学学报 (医学版), 2024, 62(2): 60-68.
[14] 宋兆录,董正璇,彭传真,黄彩娜,胡克清,黄永胜,阎磊. 肾透明细胞癌中预后相关RNA编辑位点的筛选[J]. 山东大学学报 (医学版), 2023, 61(9): 69-78.
[15] 刘艳,冷珊珊,夏晓娜,董昊,黄陈翠,孟祥水. 基于影像组学参数评估376例幕上自发性脑出血患者的功能状态[J]. 山东大学学报 (医学版), 2023, 61(5): 59-67.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
版权所有 © 2018 《山东大学学报(医学版)》编辑部　
地址:山东大学科技期刊社（济南市历城区山大南路27号山东大学中心校区明德楼B座721室） 电话: 0531-88366918 E-mail: xbyxb@sdu.edu.cn
本系统由北京玛格泰克科技发展有限公司设计开发