Matsui K, Jin X M, Kitagawa M, Miwa A
First Department of Pathology, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Japan.
Arch Pathol Lab Med. 1998 Nov;122(11):1010-7.
To clarify the clinicopathologic features of neuroendocrine carcinomas (NECs) of the stomach, we reviewed 56 cases of surgically treated gastric carcinomas with a solid growth or with areas containing patterns characteristic for neuroendocrine (NE) tumors.
Of the 56 cases reviewed, we selected 33 cases of NEC based both on histologic patterns common to NE tumors and on histochemical/immunohistochemical results.
The average age of patients with NEC was 69.8 years (range, 44-92 years). The majority of patients were men (male-female ratio, 23:10). The most frequently affected site was the upper third (46%) of the stomach. Grossly, 9 cases of NEC were fungating and 24 were ulcerated. As compared with 23 patients with non-NEC tumors, the patients with NECs had a worse prognosis. Histologically, NECs had a variety of histologic patterns, including solid, organoid, trabecular, pseudoglandular, spindle cell, and rosettelike. Based on both cell size and morphologic features, we subdivided NECs into 2 variants, namely, small cell NEC and large cell NEC. Our series included 12 cases of small cell NEC and 21 cases of large cell NEC.
Compared with small cell NECs, large cell NECs had a higher mitotic count, larger polygonal cells, a lower nuclear-cytoplasmic ratio, coarser nuclear chromatin, and more frequent conspicuous nucleoli. Large cell NEC was an aggressive tumor with a very poor prognosis (median survival time, 15.2 months; 1-year survival rate, 58%), which approached that for small cell NEC.
为阐明胃神经内分泌癌（NEC）的临床病理特征，我们回顾了56例接受手术治疗的胃癌病例，这些病例具有实性生长或包含神经内分泌（NE）肿瘤特征性模式的区域。
在回顾的56例病例中，我们基于NE肿瘤常见的组织学模式以及组织化学/免疫组织化学结果，选择了33例NEC病例。
NEC患者的平均年龄为69.8岁（范围44 - 92岁）。大多数患者为男性（男女比例为23:10）。最常受累部位是胃的上三分之一（46%）。大体上，9例NEC呈蕈伞状，24例为溃疡型。与23例非NEC肿瘤患者相比，NEC患者的预后更差。组织学上，NEC有多种组织学模式，包括实性、器官样、小梁状、假腺管状、梭形细胞和菊形团样。基于细胞大小和形态特征，我们将NEC分为2个亚型，即小细胞NEC和大细胞NEC。我们的系列病例包括12例小细胞NEC和21例大细胞NEC。
与小细胞NEC相比，大细胞NEC有更高的有丝分裂计数、更大的多边形细胞、更低的核质比、更粗的核染色质以及更频繁出现的明显核仁。大细胞NEC是一种侵袭性肿瘤，预后很差（中位生存时间为15.2个月；1年生存率为58%），接近小细胞NEC。
