대장과 직장의 신경내분비암종
Neuroendocrine Carcinoma of the Colon and Rectum
김동현, 이우용, 윤해란, 최영철, 조용범, 윤성현, 김희철, 전호경,
소속 상세정보
김동현 ( Kim Dong-Hun )
성균관대학교 의과대학 외과학교실
이우용 ( Lee Woo-Yong )
성균관대학교 의과대학 외과학교실
윤해란 ( Yun Hae-Ran )
성균관대학교 의과대학 외과학교실
최영철 ( Choi Young-Cheol )
마산삼성병원 외과
조용범 ( Cho Yong-Beom )
성균관대학교 의과대학 외과학교실
윤성현 ( Yun Seong-Hyeon )
성균관대학교 의과대학 외과학교실
김희철 ( Kim Hee-Chol )
성균관대학교 의과대학 외과학교실
전호경 ( Chun Ho-Kyung )
성균관대학교 의과대학 외과학교실
KMID : 0356720090250010046
Abstract
Purpose: The aim of this study was to review our experience with neuroendocrine carcinoma (NEC) of the colon and rectum to highlight the clinical and pathological characteristics in this relatively uncommon malignancy.
Methods: From December 1995 to December 2006, 11 patients with NEC were identified from our database of 6,143 colorectal cancer patients (0.18%), which does not include carcinoid tumors. The pathology was retrospectively reviewed and the tumors were categorized as pure NEC, including well-differentiated NEC (n=3), poorly-differentiated (n=3) and mixed endocrine/exocrine tumor (n=5) on the basis of the histology and immunohistochemical findings.
Results: The mean age of the patients was 57 yr (range, 37 to 69 yr). The tumors were located as follows: 8 in the colon and 3 in the rectum. The diagnosis of NEC was suggested preoperatively from the tissue biopsy in 2 of 9 patients (22.2%). The tumors were advanced at the time of diagnosis, with American Joint Committee on Cancer Stage III (n=7) and Stage IV disease (n=4). Most tumors stained positive by immunohistochemistry for neuroendocrine markers, including synaptophysin (7/9, 77.8%); however, chromogranin was expressed in 4 of 9 NEC tumors (44.4%). Metastatic disease was detected at the time of diagnosis in 36.4% (4/11) of the patients. The median survival for NEC was 16 mo (3.6-67.4 mo), and for pure NEC and mixed endocrine/exocrine tumor was 4.1 mo and 23.6 mo, respectively.
Conclusion: NEC had distinctive cytoarchitectural features and was often immunoreactive for neuroendocrine markers. Our findings showed that pure NEC had aggressive behavior and a poor prognosis.
키워드
신경내분비암종;결장;생존율;Chromogranin;Synaptophysin
Neuroendocrine carcinoma;Colorectal;Survival;Chromogranin;Synaptophysin
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