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神经内分泌肿瘤:一家三级医院250例病例的流行病学研究。

Neuroendocrine tumors: An epidemiological study of 250 cases at a tertiary hospital.

作者信息

Silveira Felipe, Basile Maíra Leite, Kuga Fábio Seiji, Próspero José Donato, Paes Roberto Antonio Pinto, Bernardi Fabíola Del Carlo

机构信息

Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil.

出版信息

Rev Assoc Med Bras (1992). 2017 Oct;63(10):856-861. doi: 10.1590/1806-9282.63.10.856.

Abstract

OBJECTIVE

To compare the frequency of neuroendocrine tumors in our service with that reported in the literature considering age, gender, location, degree of differentiation and increase in incidence by means of a retrospective study.

METHOD

Search of variables from a database of neuroendocrine tumor cases diagnosed at the Department of Pathological Sciences, Hospital da Santa Casa de São Paulo over the past 10 years, relating them to epidemiological data such as gender, age, distribution across organs, most-used immunohistochemical markers and presence or absence of either lymph node or distant metastases.

RESULTS

In all, 250 cases were reviewed, 133 involving females, predominantly in the 61-70 age range. The lung was the most frequent site, followed by the stomach. CD56, synaptophysin and chromogranin were the immunohistochemical markers used most often and to a lesser extent Ki67, a marker of cell proliferation that indicates a higher or lower degree of histological malignancy. Metastases, either in lymph nodes and/or distant sites, were found in 44 cases (17.6%).

CONCLUSION

The results were largely consistent with those in the literature, including age group, gender and location. Most metastases originated from high-grade tumors, with high Ki67 levels and greater impairment of the liver. However, only 36.4% of the cases had Ki67 index. Reevaluation of the Ki67 proliferative index using image analysis in doubtful cases will allow for a correlation between progression and prognosis.

摘要

目的

通过一项回顾性研究,比较本院神经内分泌肿瘤的发病频率与文献报道的情况,同时考虑年龄、性别、位置、分化程度以及发病率的上升情况。

方法

从圣保罗圣卡塔琳娜医院病理科学部过去10年诊断的神经内分泌肿瘤病例数据库中检索变量,并将其与流行病学数据相关联,如性别、年龄、器官分布、最常用的免疫组化标志物以及有无淋巴结或远处转移。

结果

共审查了250例病例,其中133例为女性,主要集中在61 - 70岁年龄段。肺部是最常见的发病部位,其次是胃部。CD56、突触素和嗜铬粒蛋白是最常用的免疫组化标志物,细胞增殖标志物Ki67的使用频率较低,Ki67可表明组织学恶性程度的高低。在44例病例(17.6%)中发现了淋巴结和/或远处转移。

结论

结果在很大程度上与文献报道一致,包括年龄组、性别和位置。大多数转移源自高级别肿瘤,Ki67水平较高,肝脏受累更严重。然而,只有36.4%的病例有Ki67指数。在可疑病例中使用图像分析重新评估Ki67增殖指数将有助于建立病情进展与预后之间的关联。

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