Rindi G, Luinetti O, Cornaggia M, Capella C, Solcia E
Department of Human Pathology, First Faculty of Medicine, University of Pavia, Italy.
Gastroenterology. 1993 Apr;104(4):994-1006. doi: 10.1016/0016-5085(93)90266-f.
Enterochromaffinlike (ECL) cell carcinoids recently observed in rats stimulated new interest in gastric endocrine tumors arising in humans.
Paraffin-embedded sections of 55 endocrine tumor cases were stained with H&E, mucin tests were performed, and immunoperoxidase was used for detecting endocrine markers; 23 cases were also investigated ultrastructurally.
Forty-five argyrophil carcinoids, 9 neuroendocrine carcinomas, and 1 gastrinoma were identified. Three clinicopathologic subtypes of carcinoids were characterized: (1) twenty-eight cases, none metastatic, arose in a background of body-fundus atrophic gastritis and hypergastrinemia; (2) seven cases, 2 locally metastatic, were associated with hypertrophic gastropathy and hypergastrinemia due to multiple endocrine neoplasia/Zollinger-Ellison syndrome; and (3) ten were sporadic cases, 7 of which were deeply invasive, 6 metastatic, and 5 histologically atypical. All carcinoids showed histochemical and ultrastructural patterns of ECL cells. The 9 neuroendocrine carcinomas, all deeply invasive and metastatic, were composed of anaplastic, small- to intermediate-sized cells with high mitotic index and focal necrosis.
Gastrin-promoted carcinoids represent a benign or low grade tumor disease, whereas sporadic carcinoids and neuroendocrine carcinomas are life-threatening neoplasms, independent of gastrin promotion.
最近在大鼠中观察到的肠嗜铬样（ECL）细胞类癌引发了人们对人类胃内分泌肿瘤的新兴趣。
对55例内分泌肿瘤病例的石蜡包埋切片进行苏木精-伊红（H&E）染色、黏液试验，并使用免疫过氧化物酶检测内分泌标志物；对其中23例还进行了超微结构研究。
共鉴定出45例嗜银性类癌、9例神经内分泌癌和1例胃泌素瘤。类癌的三种临床病理亚型具有以下特征：（1）28例，无转移，发生于胃体-胃底萎缩性胃炎和高胃泌素血症背景下；（2）7例，2例局部转移，与肥厚性胃病及由多发性内分泌肿瘤/卓-艾综合征引起的高胃泌素血症相关；（3）10例为散发性病例，其中7例浸润性深，6例转移，5例组织学上不典型。所有类癌均显示ECL细胞的组织化学和超微结构模式。9例神经内分泌癌均浸润性深且有转移，由间变的小至中等大小细胞组成，有高有丝分裂指数和局灶性坏死。
胃泌素促进型类癌代表一种良性或低级别肿瘤疾病，而散发性类癌和神经内分泌癌是危及生命的肿瘤，与胃泌素促进无关。
