11例阑尾神经内分泌肿瘤的临床与病理特征分析

摘要

Objective:To explore the clinical and pathological characteristics of neuroendocrine neoplasm of the appendix. Methods:To analyze the clinical and pathological data and HE sections of 11 cases of neuroendocrine neo-plasm of the appendix surgically removed and pathologically diagnosed by Shanghai Sixth Peopleˊs Hospital from Janu-ary 2005 to December 2012. Immunohistochemical staining of Syn,CgA,S-100,CK,Ki67 and AB/PAS of specific staining were conducted for adjuvant diagnosis. Results:Seven cases of lumps on the tip of appendix,1 case in the middle of appendix and 3 cases at the bottom of appendix;9 cases of lumps diameter≤1cm,2 cases of lumps diame-ter >1cm. 6 cases of NET G1 ,1 case of NET G2 ,1 case of NEC,3 cases of MANEC. 11 cases Syn positive,7 cases CgA positive,8 cases S-100 positive,11 cases CK positive,6 cases Ki67 <2%,1 case was 5%,3 cases 20% -40%,1 case 60%. 4 cases of specific staining AB/PAS were positive. Conclusion:Neuroendocrine neoplasm of the appendix is APUD tumor of low malignant potential,lacks the specific clinical manifestation and is difficult to be diag-nosed before surgical operations. We should put attention to the careful examination and sharp freezing of the appendix during the operation and diagnose with immunohistochemistry and specific staining examination. The prognostic effect is better.%目的：探讨阑尾神经内分泌肿瘤的临床与病理特征。方法：回顾性分析上海市第六人民医院2005年1月-2012年12月收治的经手术切除和病理确诊的11例阑尾神经内分泌肿瘤患者的临床病理资料及HE切片，并进行Syn、CgA、S-100、CK、Ki67免疫组化标记和特殊染色AB/PAS的辅助诊断。结果：肿块位于阑尾顶端7例，阑尾中部1例，基底部3例；肿块直径≤1cm者9例，直径>1cm者2例。神经内分泌瘤1级6例；神经内分泌瘤2级1例；神经内分泌癌1例；混合性腺神经内分泌癌3例。Syn阳性11例，CgA阳性7例， S-100阳性8例，CK阳性11例，Ki67其中6例<2%，1例为5%，3例为20%-40%，1例为60%；特殊染色AB/PAS阳性4例。结论：阑尾神经内分泌肿瘤为低度恶性的APUD源性肿瘤，临床上缺乏特异性，术前难以做出明确诊断，应重视术中对阑尾的仔细检查及快速冰冻，辅以免疫组织化学及特殊染色检测以确诊。预后效果较好。