Burke A B, Shekitka K M, Sobin L H
Department of Gastrointestinal Pathology, Armed Forces Institute of Pathology, Washington, D.C. 20306-6000.
Am J Clin Pathol. 1991 Mar;95(3):315-21. doi: 10.1093/ajcp/95.3.315.
The authors studied the clinical and pathologic features of 38 small cell carcinomas of the large intestine. Most were located in the right colon. Overlying adenomas were present in 45% and squamous differentiation in 21% of tumors. Endocrine differentiation was present in all tumors by at least one method; neuron-specific enolase, dense-core granules, and synaptophysin were present in most cases. Seventy-one percent of tumors metastasized to the liver; 64% of patients were dead at five months follow-up. Twenty-one poorly differentiated adenocarcinomas and undifferentiated carcinomas of the large intestine accessioned during the same period showed less endocrine (7 of 21) and squamous differentiation (1 of 15) and fewer liver metastases (4 of 15) than did small cell carcinomas. Among all 59 tumors studied, small cell histologic characteristics correlated better with liver involvement than did endocrine markers or other histologic features. Small cell carcinomas of the large intestine are aggressive tumors with a propensity for early liver involvement. Although there is a spectrum of squamous, endocrine, and glandular features in large bowel tumors of low degrees of differentiation, the identification of a small cell component appears to be most clinically relevant.
作者研究了38例大肠小细胞癌的临床和病理特征。大多数位于右半结肠。45%的肿瘤有伴发腺瘤，21%的肿瘤有鳞状分化。所有肿瘤通过至少一种方法均显示有内分泌分化；大多数病例存在神经元特异性烯醇化酶、致密核心颗粒和突触素。71%的肿瘤转移至肝脏；64%的患者在随访5个月时死亡。同期入组的21例低分化腺癌和未分化大肠癌显示出比小细胞癌更少的内分泌分化（21例中的7例）和鳞状分化（15例中的1例）以及更少的肝转移（15例中的4例）。在所有研究的59例肿瘤中，小细胞组织学特征与肝受累的相关性比内分泌标志物或其他组织学特征更好。大肠小细胞癌是侵袭性肿瘤，倾向于早期累及肝脏。尽管低分化大肠肿瘤存在鳞状、内分泌和腺性特征谱，但小细胞成分的识别似乎在临床上最为相关。
