Macak Jirka, Nemejcova Kristina, Dvorackova Jana
Department of Pathology, University of Ostrava and University Hospital Ostrava, Czech Republic.
CGB Laboratory Inc., Ostrava, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2017 Sep;161(3):281-285. doi: 10.5507/bp.2017.027. Epub 2017 Jun 12.
Goblet cell carcinoids belong to neuroendocrine tumors, according to the WHO classification. The tumors are diagnosed based on a typical histological pattern and using neuroendocrine markers. However, some tumors do not react with these markers and yet expression of proliferative markers is high. Do these tumors belong to G1 and G2 neuroendocrine tumors?
The sample comprised nine cases of tumors of the appendix identified by immunohistological methods as goblet cell carcinoids or adenocarcinoma ex goblet cell carcinoid.
In six cases, hematoxylin and eosin staining revealed tumors completely or 90% made of characteristic large tumor cells observed in typical goblet cell carcinoids. The remaining three cases were identified as adenocarcinomas arising ex goblet cell carcinoids. Immunohistological examination revealed that in four cases of typical goblet cell carcinoids, expression of neuroendocrine markers was low or completely negative. Yet in two cases, the Ki-67 proliferative index exceeded the 20% cut-off for inclusion in the G1 and G2 category.
Goblet cell carcinoids are a heterogeneous group of tumors that may express neuroendocrine markers in a small number of tumor cells or are negative to these markers. However, high expression of the proliferative marker Ki-67 exceeds the criteria for G1 and G2 neuroendocrine tumors. It is our opinion that these tumors may be classified as a specific type of carcinoma.
根据世界卫生组织的分类，杯状细胞类癌属于神经内分泌肿瘤。这些肿瘤通过典型的组织学模式并使用神经内分泌标志物进行诊断。然而，一些肿瘤对这些标志物无反应，但增殖标志物的表达却很高。这些肿瘤属于G1和G2神经内分泌肿瘤吗？
该样本包括9例经免疫组织学方法鉴定为杯状细胞类癌或杯状细胞类癌来源的腺癌的阑尾肿瘤病例。
6例中，苏木精-伊红染色显示肿瘤完全或90%由典型杯状细胞类癌中观察到的特征性大肿瘤细胞组成。其余3例被鉴定为杯状细胞类癌来源的腺癌。免疫组织学检查显示，在4例典型杯状细胞类癌中，神经内分泌标志物的表达低或完全阴性。然而，在2例中，Ki-67增殖指数超过了纳入G1和G2类别的20%临界值。
杯状细胞类癌是一组异质性肿瘤，可能在少数肿瘤细胞中表达神经内分泌标志物或对这些标志物呈阴性。然而，增殖标志物Ki-67的高表达超过了G1和G2神经内分泌肿瘤的标准。我们认为这些肿瘤可归类为一种特殊类型的癌。
