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微小类癌病中胃内分泌细胞的模式——14例胃活检组织的免疫组织化学研究

Pattern of gastric endocrine cells in microcarcinoidosis--an immunohistochemical study of 14 gastric biopsies.

作者信息

Reinecke P, Borchard F

机构信息

Department of Pathology, Heinrich Heine University, Düsseldorf, Germany.

出版信息

Virchows Arch. 1996 Jul;428(4-5):237-41. doi: 10.1007/BF00196696.

Abstract

A total of 14 gastric biopsy specimens from patients with microcarcinoidosis were analysed by immunohistochemical methods to evaluate the pattern of endocrine cell hyperplasia and dysplasia. All the patients had type A gastritis (autoimmune gastritis). Nonantral proliferations of gastric endocrine cells were classified according to Solcia et al. All 14 cases had hyperplasia and 13 (92.9%) of them, dysplasia of gastric endocrine cells; 9 (64.3%) of the 14 were found to have showed a coexisting invasive gastric carcinoid at the time of diagnosis of microcarcinoidosis. The patients with invasive carcinoids had higher degrees and more complex forms of endocrine dysplasia (precarcinoid lesions). The average size of the foci of the microcarcinoidosis in gastric biopsies was 0.14 +/- 0.09 cm in the patients without invasive carcinoid, as against to 0.5 +/- 0.24 cm in the group of patients with associated invasive carcinoid. Microcarcinoid gastric biopsies about 0.5 cm in size, are suggestive of adjacent invasive carcinoid. However, even frankly invasive ECL carcinoids seem to be clinically less dangerous than was thought until recently.

摘要

采用免疫组化方法对14例微类癌患者的胃活检标本进行分析,以评估内分泌细胞增生和发育异常的模式。所有患者均患有A型胃炎(自身免疫性胃炎)。胃内分泌细胞的非胃窦部增生按照索尔恰等人的方法进行分类。14例患者均有增生,其中13例(92.9%)存在胃内分泌细胞发育异常;在微类癌诊断时,14例中有9例(64.3%)同时存在浸润性胃类癌。浸润性类癌患者的内分泌发育异常(类癌前病变)程度更高且形式更复杂。胃活检中微类癌灶的平均大小在无浸润性类癌的患者中为0.14±0.09厘米,而在伴有浸润性类癌的患者组中为0.5±0.24厘米。大小约0.5厘米的胃微类癌活检提示存在相邻的浸润性类癌。然而,即使是明显浸润性的肠嗜铬样细胞(ECL)类癌,其临床危险性似乎也比直到最近所认为的要低。

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