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胃大细胞神经内分泌癌的临床病理特征：2 例系列报告及文献复习。

Clinical and pathological characteristics of gastric large cell neuroendocrine carcinoma: A report of 2 cases series and literature review.

机构信息

Department of Pathology, Xingtai People's Hospital, Hebei Medical University Affiliated Hospital, Xingtai, Hebei, P.R. China.

Endoscopic Center, Xingtai People's Hospital, Hebei Medical University Affiliated Hospital, Xingtai, Hebei, P.R. China.

出版信息

Medicine (Baltimore). 2024 Oct 4;103(40):e39851. doi: 10.1097/MD.0000000000039851.

DOI:10.1097/MD.0000000000039851
PMID:39465709
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11460907/
Abstract

RATIONALE

Gastric large cell neuroendocrine carcinoma (LCNEC) is a rare, aggressive neuroendocrine carcinoma that arises from the stomach and with high malignancy. Patients with gastric LCNEC usually have a poor prognosis. The standard treatment plan has not been established and its curative effect is poor. The present study described 2 cases diagnosed with gastric LCNEC and reviewed in depth the literature to improve our understanding more about this uncommon tumor and further to provide more experience to diagnose and treat this disease.

PATIENT CONCERNS

The present study reported 2 cases of gastric LCNEC in male patients aged 51 and 73 years old, respectively. Both patients had epigastric discomfort, pain, acid reflux and heartburn. The medical history was unremarkable.

DIAGNOSES

The ulcerative lesion located at gastric was examined in the 2 patients by taking the esophagogastroduodenoscopy (EGO), computed tomography (CT) and digital gastrointestinal radiography (GI), that both were suspected gastric malignancy. Endoscopic biopsies of the tumor led to the initial diagnosis of gastric cancer. Postoperative pathological and immunohistochemical examinations of the surgical specimens confirmed that 1 case had mixed adeno-neuroendocrine carcinoma (MANEC) and the other had LCNEC.

INTERVENTIONS

Both patients underwent surgical resection and received etoposide-cisplatin combination chemotherapy following surgery.

OUTCOMES

The operation was successful. Both patients had uneventful recoveries following surgery, and had been followed-up regularly. The general condition was satisfactory, and no tumor metastasis was observed at present.

摘要

背景

胃大细胞神经内分泌癌（LCNEC）是一种罕见的、侵袭性的神经内分泌癌，起源于胃，恶性程度高。胃 LCNEC 患者通常预后较差。目前尚未确立标准治疗方案，疗效不佳。本研究描述了 2 例胃 LCNEC 患者，并对文献进行了深入复习，旨在提高对这种罕见肿瘤的认识，并为诊断和治疗该病提供更多经验。

病例报告

本研究报道了 2 例男性胃 LCNEC 患者，年龄分别为 51 岁和 73 岁。均表现为上腹部不适、疼痛、反酸、烧心。无特殊病史。

诊断

2 例患者均经食管胃十二指肠镜（EGO）、计算机断层扫描（CT）和数字胃肠造影（GI）检查发现胃内溃疡性病变，均怀疑为胃癌。肿瘤的内镜活检初步诊断为胃癌。术后病理和免疫组织化学检查证实 1 例为混合性腺神经内分泌癌（MANEC），另 1 例为 LCNEC。

干预措施

2 例患者均接受手术切除，术后接受依托泊苷联合顺铂化疗。

结果

手术成功。2 例患者术后均恢复顺利，定期随访。一般情况良好，目前未发现肿瘤转移。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/12ee/11460907/dcdba8adf26f/medi-103-e39851-g008.jpg
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