Chiba Naokazu, Suwa Tatsushi, Hori Masao, Sakuma Masayoshi, Kitajima Masaki
Department of Surgery, School of Medicine, Keio University, Tokyo, Japan.
Gastric Cancer. 2004;7(2):122-7. doi: 10.1007/s10120-004-0279-2.
Gastric pure endocrine cell carcinoma (ECC) is extremely rare. ECC occasionally shows multidirectional differentiation; that is, adenocarcinomatous and/or squamous proliferation. Because gastric ECC has aggressive biological behavior and shows frequent metastasis to liver and lymph nodes even in the early stage, the prognosis of patients having this disease is extremely poor. We treated a 75-year-old woman with advanced gastric pure ECC with total gastrectomy and lymph node dissection, and reviewed all the previously reported cases of this disease. We compared the clinicopathological findings of ECC with those of gastric carcinoma (GC) and found that ECC had significantly more frequent invasion to lymphatic and vascular lumens ( P < 0.01) and more frequent metastasis to lymph nodes ( P < 0.01) and liver ( P < 0.05) compared to GC. Gastric ECC smaller than 5 cm in the greatest dimension showed a higher percentage of advanced lesions (>T2) than GC ( P < 0.05), which could result in the difficulty of finding early ECC. The findings of the analyses we made in this report may account for the poor prognosis of this disease.
胃纯内分泌细胞癌（ECC）极为罕见。ECC偶尔会呈现多向分化，即腺癌和/或鳞状上皮增生。由于胃ECC具有侵袭性生物学行为，甚至在早期就常发生肝转移和淋巴结转移，因此患有这种疾病的患者预后极差。我们对一名75岁晚期胃纯ECC女性患者进行了全胃切除术和淋巴结清扫，并回顾了所有先前报道的该疾病病例。我们将ECC的临床病理特征与胃癌（GC）的进行了比较，发现与GC相比，ECC侵犯淋巴管和血管腔的频率显著更高（P < 0.01），淋巴结转移（P < 0.01）和肝转移（P < 0.05）的频率也更高。最大径小于5 cm的胃ECC中进展期病变（>T2）的比例高于GC（P < 0.05），这可能导致早期ECC难以发现。我们在本报告中所做分析的结果可能解释了这种疾病预后不良的原因。
