Institute of Anatomic Pathology, Università Cattolica del Sacro Cuore - Policlinico A. Gemelli, Largo A. Gemelli, 8, Rome I-00168, Italy.
Endocrinol Metab Clin North Am. 2010 Dec;39(4):713-27. doi: 10.1016/j.ecl.2010.08.009.
Nonneoplastic and neoplastic proliferative lesions of endocrine cells of the gastrointestinal tract are detailed. A multistep continuum from hyperplasia, dysplasia to neoplasia is identified for histamine-producing enterochromaffin-like (ECL) cells of the gastric corpus. Most gastric neuroendocrine tumors (NETs) are silent and composed by ECL cells, the second most frequent neuroendocrine neoplasms being the high-grade neuroendocrine carcinoma (NEC). In the duodenum, preneoplastic lesions are similarly described for gastrin (G) and somatostatin (D) cells. G-cell NETs are the most frequent neuroendocrine tumors of the duodenum, either functioning or nonfunctioning, followed by D-cell NETs and gangliocytic paraganglioma (GCP). No systematic definition of nonneoplastic lesions exists for endocrine cells of the ileum, appendix, and colon-rectum. The most frequent ileal NETs are serotonin-producing enterochromaffin (EC)-cell NETs (classic carcinoid), associating with functional syndrome only in presence of liver metastases. Neoplasms are usually larger in the colon as compared with the small lesions observed in the rectum. High-grade NECs are observed in the colon and rectum-sigmoid, often associate with nonendocrine neoplastic components, and fare an aggressive course with poor outcome and short survival.
胃肠道内分泌细胞的非肿瘤性和肿瘤性增生性病变有详细描述。胃体部产生组胺的肠嗜铬样（ECL）细胞经历了从增生、异型增生到肿瘤的多步骤连续过程。大多数胃神经内分泌肿瘤（NET）是无功能性的，由 ECL 细胞组成，第二常见的神经内分泌肿瘤是高级别神经内分泌癌（NEC）。在十二指肠，同样描述了胃泌素（G）和生长抑素（D）细胞的癌前病变。G 细胞 NET 是最常见的十二指肠神经内分泌肿瘤，无论是功能性还是无功能性，其次是 D 细胞 NET 和神经节细胞瘤（GCP）。对于回肠、阑尾和结肠-直肠的内分泌细胞，没有关于非肿瘤性病变的系统定义。最常见的回肠 NET 是产生 5-羟色胺的肠嗜铬（EC）细胞 NET（经典类癌），仅在存在肝转移时才与功能性综合征相关。肿瘤通常比在直肠中观察到的小病变更大。高级别 NEC 见于结肠和直肠-乙状结肠，常与非内分泌性肿瘤成分相关，具有侵袭性病程和不良预后及短生存期。
