Department of Surgery, Kansai Rousai Hospital, 3-1-69 Inabaso, Amagasaki City, Hyogo 660-8511, Japan.
World J Surg Oncol. 2012 Jun 22;10:115. doi: 10.1186/1477-7819-10-115.
Gastric neuroendocrine carcinoma (G-NEC) is a rare, highly malignant tumor that exhibits aggressive growth leading to vascular invasion, distant metastasis and extremely poor prognosis. We studied the clinicopathological findings of seven patients at our institute to better under this disease.
Seven cases of G-NEC were identified among 1,027 cases of gastric carcinoma that underwent gastrectomy at Kansai Rousai Hospital between 2002 and 2010. We studied the pathological and immunohistochemical features of gastric neuroendocrine carcinomas at both the primary site and metastatic lymph nodes.
The mean patient age was 73 years (range 63 to 86 years). There were no females in this series. The final staging was Stage I in one case, Stage II in two, Stage III in two and Stage IV in two. A total of 31 metastatic lymph nodes were found in these patients. This study revealed that the ratio of neuroendocrine cells was similar between the primary and metastatic sites, which tended to show the same expression patterns of neuroendocrine markers.
Metastatic lymph nodes showed heterogeneous immunohistochemical expression patterns similar to the primary sites. G-NEC is far advanced at diagnosis and rapidly reaches the lymph nodes retaining its heterogeneity, carrying a worse prognosis than common gastric cancer. MINI ABSTRACT: G-NEC grows rapidly and metastasizes to the lymph nodes, retaining its pathological and immunohistochemical heterogeneity even at the metastatic sites.
胃神经内分泌癌（G-NEC）是一种罕见的高度恶性肿瘤，其生长具有侵袭性，易发生血管侵犯、远处转移，预后极差。为了更好地了解这种疾病，我们对我院 7 例 G-NEC 患者的临床病理资料进行了研究。
对我院 2002 年至 2010 年间 1027 例胃癌手术患者的资料进行回顾性研究，从中确定了 7 例 G-NEC 患者。研究了胃神经内分泌癌原发灶和转移淋巴结的病理和免疫组织化学特征。
患者平均年龄为 73 岁（63-86 岁），均为男性，无女性患者。分期：Ⅰ期 1 例，Ⅱ期 2 例，Ⅲ期 2 例，Ⅳ期 2 例。共发现 31 枚转移淋巴结。本研究表明，神经内分泌细胞在原发灶和转移灶中的比例相似，其神经内分泌标志物的表达模式也趋于相同。
转移淋巴结的免疫组织化学表达模式与原发灶存在异质性。G-NEC 在诊断时已处于晚期，且迅速转移至淋巴结，并保留其异质性，预后比普通胃癌更差。
