促泌素在胃肠道神经内分泌肿瘤中的表达及其临床意义

目的 比较促泌素(secretagogin,SCGN)与传统的神经内分泌标记物在胃肠道神经内分泌肿瘤中的表达差异.方法 收集胃肠道手术标本共88例,其中实验组为8例类癌和20例非典型类癌,对照组为40例腺癌伴神经内分泌分化和20例腺癌.所有标本均使用SCGN、PGP9.5、CD56、NSE、Syn及CgA进行免疫组织化学SP两步法染色.结果 SCGN可在胃肠道粘膜同有层腺体的弥散性神经内分泌细胞中表达,多显示“开放型”的神经内分泌细胞.除CD56和NSE各在1例胃肠道腺癌中阳性表达外,SCGN及其它标记物在20例腺癌中均无表达,所有标记物之间均无统计学差异(P＞0.05).SCGN在40例胃肠道腺癌伴神经内分泌分化、20例非典型类癌和8例类癌巾的阳性表达率均最高,分别为62.5％ (25/40)、90％(18/20)和100％(8/8),PGP9.5阳性表达率均最低分别为32.5％(13/40)、45％ (9/20)和37.5％(3/8),两标记物在这三组肿瘤中的表达均有显著统计学差异(P＜0.01),而CD56、NSE、Syn和CgA在以上三组肿瘤中的表达率均较高,与SCGN比较均无统计学差异(P＞0.05).所有标记物在腺癌伴神经内分泌分化、非典型类癌和类癌中的阳性表达率均明显高于腺癌(P＜0.01);SCGN、Syn和CgA在非典型类癌和类癌巾的阳性表达均高于腺癌伴神经内分泌分化(P＜0.05)；所有标记物在非典型类癌和类癌之间的阳性表达率均无统计学差异(P＞0.05).结论 SCGN作为一种新型的神经内分泌标记物与传统标记物Syn和CgA联合,可应用于胃肠道神经内分泌肿瘤的临床病理诊断.

Expression and significance of secretagogin in gastrointestinal neuroendocrine tumors

Objective To investigate the different expressions between secretagogin（SCGN） and traditional neuroendocrine markers in gastrointestinal neuroendocrine tumors. Methods Eighty-eight samples of gastrointestinal tumors were collected,including 8 carcinoid and 20 atypical carcinoid cases in the experimental group;40 adenocarcinoma with focal neuroendocrine differentiation and 20 adenocarcinoma as the control group.All specimens were detected by streptavidin-peroxidase two-step immunohistochemical method.For SCGN and 5 conventional neuroendocrine markers PGP9.5,CD56,NSE,Syn and CgA. Results SCGN showed positive staining in neuroendocrine cells of the lamina propria gland in normal gastrointestinal mucosa.Most SCGN expression was in the so called ＂open＂ neuroendocrine cells.CD56 and NSE were each positive in one of adenocarcinomas,while SCGN,PGP9.5,Syn and CgA were negative in all adenocarcinomas.The expression of all markers in adenocarcinomas had no statistical significance（P0.05）.The positive rates of SCGN were the highest in 25 of 40（62.5%） adenocarcinomas with focal neuroendocrine differentiation,18 of 20（90%） atypical carcinoids and 8 of 8（100%） carcinoids,which were obviously different from those of PGP9.5（32.5%,45% and 37.5%,respectively）（P0.01）.Meanwhile,the positive rates of CD56,NSE,Syn and CgA were similar to those of SCGN,with no significant differences（P0.05）.The positive rates of all markers in adenocarcinomas with focal neuroendocrine differentiation,atypical carcinoids and carcinoids were significantly higher than those in adenocarcinomas（P0.01,respectively）.The expressions of SCGN,Syn and CgA in atypical carcinoid and carcinoid were higher than those in adenocarcinomas with focal neuroendocrine differentiation（P0.05,respectively）.However,the positive rates of all markers had no significant differences between atypicalcarcinoid and carcinoid（P0.05）. Conclusion SCGN is a novel neuroendocrine marker.A combination of SCGN,Syn and CgA could serve as pathological diagnostic markers for gastrointestinal neuroendocrine tumors.