Zhu Xiaolong, Jing Haiyan, Yao Takashi
Department of Cardiac Surgery.
Department of Pathology, Shandong Provincial Hospital affiliated to Shandong University, Jinan 250021, China.
Medicine (Baltimore). 2019 Jul;98(30):e16638. doi: 10.1097/MD.0000000000016638.
Gastric neuroendocrine carcinoma (NEC) is rare. It is considered to be aggressive and has a poor prognosis since the diagnosis is usually made at its advanced stage. However, the survival rate is increased in some early gastric NECs. This study showed a case and reviewed the clinical characteristics of early NECs in stomach.
A 38-year-old man displayed no symptoms and underwent the gastric endoscopy test for his health examination, which showed a red slightly depressed lesion 1.0 cm in size on the lesser curvature of gastric cardia. Magnifying endoscopy with narrow-band imaging (NBI) revealed a clear demarcation and an irregular mesh in vessels within the depressed area. The background mucosa was negative for atrophic gastritis and Helicobacter Pylori infection. A contrast-enhanced computed tomography (CT) scan disclosed no obvious thickening of stomach and lymphadenopathy. Blood tests and physical examination were unremarkable. He had not received any surgical treatment and denied a family history of cancer and any genetic disorders. The pathologic result of biopsy from the lesion was suspicious of superficial carcinoma. Then endoscopic submucosal dissection (ESD) was performed.
Gastric NEC G3 in the early stage (T1aN0M0).
Concerning this patient's situation, we considered the ESD as a curable treatment. And no radical surgery or adjuvant chemotherapy was arranged.
The patient is doing well and displays no recurrence for 11 months, who is still in follow-up.
The early diagnosis and effective treatment by endoscopy would contribute to improve the prognosis of gastric NECs.
胃神经内分泌癌(NEC)较为罕见。它被认为具有侵袭性,且由于通常在晚期才得以诊断,预后较差。然而,部分早期胃NEC的生存率有所提高。本研究展示了1例病例,并回顾了早期胃NEC的临床特征。
一名38岁男性无症状,因健康检查接受了胃镜检查,结果显示在贲门小弯处有一个大小为1.0厘米的红色略凹陷病变。窄带成像放大内镜检查(NBI)显示凹陷区域内血管有清晰的边界和不规则的网状结构。背景黏膜萎缩性胃炎和幽门螺杆菌感染均为阴性。增强计算机断层扫描(CT)显示胃无明显增厚及淋巴结肿大。血液检查和体格检查均无异常。他未接受过任何手术治疗,否认有癌症家族史及任何遗传疾病。病变活检的病理结果怀疑为浅表癌。随后进行了内镜黏膜下剥离术(ESD)。诊断:早期胃NEC G3(T1aN0M0)。
针对该患者的情况,我们认为ESD是一种可治愈的治疗方法。未安排根治性手术或辅助化疗。
患者情况良好,11个月未复发,仍在随访中。
早期内镜诊断及有效治疗有助于改善胃NEC的预后。