Kitano Yuto, Kinoshita Jun, Oyama Katsunobu, Okamoto Koichi, Sakai Seisho, Makino Isamu, Nakamura Keishi, Hayashi Hironori, Inokuchi Masafumi, Miyashita Tomoharu, Tajima Hidehiro, Takamura Hiroyuki, Ninomiya Itasu, Fushida Sachio, Ohta Tetsuo
Dept. of Gastroenterologic Surgery, Kanazawa University.
Gan To Kagaku Ryoho. 2017 Nov;44(12):1226-1228.
Gastric cancer rarely contains neuroendocrine component. This mixed tumor is defined as neuroendocrine carcinoma (NEC), mixed adenoneuroendocrine carcinoma(MANEC)and so on according to the WHO classification. We report a patient with esophagogastric junction cancer with neuroendocrine differentiation(NED). The patient was 54-year-old man who diagnosed of esophagogastric junction cancer at the medical examination. Upper gastrointestinal endoscopy revealed a type 3 tumor at esophagogastric junction, and the pathological findings were poorly differentiated adenocarcinoma with focal positivity of chromogranin A. CT and FDG/PET revealed a metastatic regional lymph node. He had undergone proximal gastrectomy and lower esophagectomy, with dissection of D1+and double-tract reconstruction. Pathological findings revealed moderate to poorly differentiated adenocarcinoma containing chromogranin A-positive tumor cells. Neuroendocrine components were lower than 30%, and we diagnosed adenocarcinoma with NED. Standard treatment for gastric cancer with NED has not been established and more reports and reviews are required.
胃癌很少含有神经内分泌成分。根据世界卫生组织的分类，这种混合性肿瘤被定义为神经内分泌癌（NEC）、混合性腺神经内分泌癌（MANEC）等。我们报告了一例具有神经内分泌分化（NED）的食管胃交界癌患者。该患者为一名54岁男性，在体检时被诊断为食管胃交界癌。上消化道内镜检查显示食管胃交界处有一个3型肿瘤，病理结果为低分化腺癌，嗜铬粒蛋白A呈局灶阳性。CT和FDG/PET显示有区域淋巴结转移。他接受了近端胃切除术和食管下段切除术，并进行了D1+清扫和双通道重建。病理结果显示为中至低分化腺癌，含有嗜铬粒蛋白A阳性肿瘤细胞。神经内分泌成分低于30%，我们诊断为伴有NED的腺癌。伴有NED的胃癌的标准治疗方法尚未确立，需要更多的报告和综述。
