Hong Liangli, Zhang Ying, Liu Zhaoyong
Department of Pathology, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
Department of Pathology, Shantou University Medical College, Shantou, Guangdong, China.
Oncotarget. 2017 Dec 22;9(12):10754-10764. doi: 10.18632/oncotarget.23610. eCollection 2018 Feb 13.
Neuroendocrine carcinoma (NEC) of the esophagus and gastric cardia is a rare tumor, and the Chaoshan region has one of the highest incidences of esophageal and gastric cardia cancer (GCC) worldwide. The aim of this study was to characterize the clinicopathologic features of esophageal NEC ( = 67) and gastric cardia NEC ( = 13) cases identified over a 9-year period in the Chaoshan region. Esophageal NECs were either purely NEC ( = 47) or mixed with squamous cell carcinoma or adenocarcinoma ( = 20). For GCC; pure NEC was found in 5 cases, whereas 8 cases were mixed with adenocarcinomas. The majority of esophageal and gastric cardia NECs was of the small cell type, and 24/67 esophageal and 5/13 gastric cardia patients were found with lymph node metastasis. Immunohistochemistry was performed in all cases, and positive staining for synaptophysin (Syn) was found for all cases, with half the esophageal NEC cases being also chromogranin A (CgA)-positive. In the multivariate Cox regression model, lymph node and further metastasis were independent prognostic factors for esophageal NEC. Our study revealed the clinicopathological features of esophageal and gastric cardia NECs in the Chaoshan region and found mixed NECs patients may have a better prognosis than pure NECs patients, which may provide therapeutic clue for treating this rare tumor.
食管和贲门神经内分泌癌（NEC）是一种罕见肿瘤，而潮汕地区是全球食管癌和贲门癌（GCC）发病率最高的地区之一。本研究旨在描述潮汕地区9年间确诊的67例食管NEC和13例贲门NEC病例的临床病理特征。食管NEC要么是纯NEC（47例），要么与鳞状细胞癌或腺癌混合（20例）。对于GCC，5例为纯NEC，8例与腺癌混合。大多数食管和贲门NEC为小细胞型，67例食管NEC患者中有24例、13例贲门NEC患者中有5例发生淋巴结转移。所有病例均进行了免疫组织化学检查，所有病例突触素（Syn）染色均为阳性，一半的食管NEC病例嗜铬粒蛋白A（CgA）染色也为阳性。在多因素Cox回归模型中，淋巴结转移和远处转移是食管NEC的独立预后因素。我们的研究揭示了潮汕地区食管和贲门NEC的临床病理特征，发现混合性NEC患者的预后可能优于纯NEC患者，这可能为治疗这种罕见肿瘤提供治疗线索。
