von Herbay A, Sieg B, Schürmann G, Hofmann W J, Betzler M, Otto H F
Institute of Pathology, University of Heidelberg, Germany.
Gut. 1991 Aug;32(8):949-53. doi: 10.1136/gut.32.8.949.
The proliferative activity of 16 tumour specimens from 13 patients with neuroendocrine tumours of the gastroenteropancreatic endocrine system was studied by DNA flow cytometry and immunohistology for the nuclear Ki67 proliferation antigen. Equivalent results were obtained with both methods, which showed the proliferative activity of gastroenteropancreatic neuroendocrine tumours to be heterogeneous. In four malignant small intestinal carcinoids and one extravisceral carcinoid localised in the retroperitoneum the percentage (index) of proliferating tumour cells as measured by DNA flow cytometry ranged from 2.9 to 36.2% corresponding to low, moderate, or high proliferative activity. In four malignant pancreatic endocrine tumours and their metastases indices ranged from 8.7 to 18.3%, corresponding to low, moderate, or high proliferative activity. In four benign pancreatic endocrine tumours indices ranged from 4.3 to 7.7%, all corresponding to low proliferative activity. This heterogeneity of proliferative activity may in part explain the heterogeneous results reported of chemotherapy treatment. As chemotherapy of tumours is largely affected by favourable cell cycling kinetics, individual diagnostic investigations of the proliferative activity of these neuroendocrine tumours may be of value for identifying patients suitable for this treatment.
采用DNA流式细胞术和免疫组织化学方法检测核Ki67增殖抗原，对13例胃肠胰内分泌系统神经内分泌肿瘤患者的16份肿瘤标本的增殖活性进行了研究。两种方法得到了等效结果，均显示胃肠胰神经内分泌肿瘤的增殖活性具有异质性。在4例恶性小肠类癌和1例位于腹膜后的内脏外类癌中，通过DNA流式细胞术测得的增殖肿瘤细胞百分比（指数）范围为2.9%至36.2%，分别对应低、中或高增殖活性。在4例恶性胰腺内分泌肿瘤及其转移灶中，指数范围为8.7%至18.3%，分别对应低、中或高增殖活性。在4例良性胰腺内分泌肿瘤中，指数范围为4.3%至7.7%，均对应低增殖活性。增殖活性的这种异质性可能部分解释了化疗治疗结果的异质性。由于肿瘤化疗在很大程度上受有利的细胞周期动力学影响，对这些神经内分泌肿瘤的增殖活性进行个体诊断研究可能对确定适合该治疗的患者具有价值。
