The Clinicopathological Characteristics of Gastrointestinal Neuroendocrine Tumors; An Analysis of 65 Cases
이현주, 최정우, 김애리, 안준석, 김현철, 신봉경, 김한겸, 김인선,
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이현주 ( Lee Hyun-Joo )
고려대학교 의과대학 병리학교실
최정우 ( Choi Jung-Woo )
고려대학교 의과대학 해부병리과학교실
김애리 ( Kim Ae-Ree )
고려대학교 의과대학 병리학교실
안준석 ( An Jung-Suk )
고려대학교 의과대학 병리학교실
김현철 ( Kim Hyun-Chul )
고려대학교 의과대학 병리학교실
신봉경 ( Shin Bong-Kyung )
고려대학교 의과대학 병리학교실
김한겸 ( Kim Han-Kyeom )
고려대학교 의과대학 병리학교실
김인선 ( Kim In-Sun )
고려대학교 의과대학 병리학교실
KMID : 0357920070410030149
Abstract
Background : This study was designed to investigate gastrointestinal neuroendocrine tumors with an emphasis on their clinicopathological characteristics.
Methods : Sixty-five cases were reviewed and classified as typical carcinoid (TC), atypical carcinoid (AC), large cell neuroendocrine carcinoma (LCNEC) and small cell carcinoma (SmCC). We performed immunohistochemistry to characterize the expression of the immunoreactivity for synaptophysin, chromogranin, gastrin, somatostatin, thyroid transcription factor-1, p53 and Ki-67.
Results : Most commonly, the tumors were located in the rectum (54%), followed by the stomach (23%) and colon (9%). Histologically, the tumors were classified as 49 TCs, 4 ACs, 6 LCNECs and 6 SmCCs. Most tumors were stained positive for synaptophysin and/or chromogranin. Four LCNECs and one SmCC were p53-positive. The carcinoids revealed a low level (<5%) of reactivity for Ki-67, while > or =30% of the cells showed reactivity for Ki-67 in the majority of LCNECs and SmCCs. Six patients with metastatic carcinoids were older than those patients without metastasis (64 vs 48 years, respectively, p=0.004). Furthermore, the size of tumors was larger for the patients with metastatic carcinoids than for the patients with nonmetastatic carcinoids (2.3 vs 0.5 cm, respectively, p=0.005).
Conclusion : Old age, large tumor size and muscle invasion are associated with high grade neuroendocrine tumor and lymph node metastasis for those patients with carcinoids.
키워드
Gastrointestinal tract;Carcinoid tumor;Small cell carcinoma;Neuroendocrine carcinoma;p53; Ki-67
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