Stachura Tomasz, Strzałka Marcin, Bolt Leszek
II Katedra Chirurgii Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie.
Przegl Lek. 2003;60(12):782-8.
Carcinoids develop from neuroendocrine cells. These cells share the same origin from ancestor stem cells in the regenerative zone of the gut. There are a few types of neuroendocrine cells in the stomach, mainly: G cells (antrum), D cells (corpus and antrum), ECL cells (corpus and fundus), D1 cells, EC cells, P cells and X cells. Each type of the endocrine cell is able to a tumor formation, but the gastric carcinoids are most likely to derive from ECL cells. The dominant type of cells of the corpus and fundus mucosa are the ECL cells. They constitute up to 30-40% of the neuroendocrine cells of the stomach and release histamine which is responsible for parietal cells stimulation. Hypergastrinemia predisposes ECL cells to proliferation. There is a continuity of changes ranging from simple hyperplasia to ECL cells carcinoids (often multiple). Among three types of gastric carcinoids, type three is aggressive and highly malignant, while type one is the most common but of low malignant potential. This publication presents 7 patients with extensive ECL cells hyperplasia and type 1 gastric carcinoids. The endocrine cells and carcinoids were visualized with the immunohistochemical reaction to chromogranin A. Prolonged, lasting several years observations of some of the patients under study confirm the indolent character of the disease. Individual, type-adapted, conservative treatment is sufficient.
类癌由神经内分泌细胞发展而来。这些细胞与肠道再生区的祖干细胞有着相同的起源。胃内有几种类型的神经内分泌细胞,主要包括:G细胞(胃窦)、D细胞(胃体和胃窦)、肠嗜铬样细胞(ECL细胞,胃体和胃底)、D1细胞、肠嗜铬细胞(EC细胞)、P细胞和X细胞。每种内分泌细胞都有形成肿瘤的能力,但胃类癌最有可能源自ECL细胞。胃体和胃底黏膜的主要细胞类型是ECL细胞。它们占胃神经内分泌细胞的30% - 40%,并释放组胺,组胺可刺激壁细胞。高胃泌素血症易使ECL细胞增殖。从单纯增生到ECL细胞类癌(通常为多发)存在一系列连续变化。在三种类型的胃类癌中,三型具有侵袭性且恶性程度高,而一型最为常见但恶性潜能低。本出版物介绍了7例广泛ECL细胞增生和1型胃类癌患者。通过对嗜铬粒蛋白A的免疫组化反应使内分泌细胞和类癌可视化。对部分研究患者进行的长达数年的观察证实了该疾病的惰性特征。个体化的、适应类型的保守治疗就足够了。