胃腸道神經(jīng)內(nèi)分泌腫瘤課件

神內(nèi)分泌腫瘤鄭大一附TheFirstAffiliatedHospitalofZhengzhouUniversity●流行病學(xué)●臨床表現(xiàn)診斷●治療●預(yù)后TheFirstAffiliatedHospitalofZhengzhouUniversity神經(jīng)內(nèi)分泌腫瘤是一類(lèi)起源于胚胎的神經(jīng)內(nèi)分泌細(xì)胞、具有神經(jīng)內(nèi)分泌標(biāo)記物和可以生多肽激素的腫瘤。TheFirstAffiliatedHospitalofZhengzhouUniversityHo2000WHO2010Well-differentiatedneuroendocrinetumorBenignorUncertainmalignantpotentialNeuroendocrineTumor,grade1or2Well-differentiatedneuroendocrinecarcinomaLow-grademalignantPoorlydifferentiatedNeuroendocrinecarcinoma,grade3SmallcellneuroendocrinecarcinomaHiah-arademalignantLargecellTheFirstAffiliatedHospitalofZhengzhouUniversity混合腺神經(jīng)內(nèi)分泌癌MANECDCCNECTheFirstAffiliatedHospitalofZhengzhouUniversity分級(jí)1級(jí)2級(jí)3級(jí)K67指數(shù)≤23-20>20M2-20安態(tài)行>2,?高1.RindiG,etal.virchowsArch/v2006,449:395-401.2.RindiG,etal.VirchowsArch/v2007:451:757-762TheFirstAffiliatedHospitalofZhengzhouUniversity中華理學(xué)雜志2011年4月第40卷第4期ChinJPathol,April20lvd-40,Na香神經(jīng)內(nèi)分泌瘤(neuroendocrinetumor,NET)規(guī)范中國(guó)胃腸胰NETI(鑿癌carcinoid中國(guó)胃楊胰神經(jīng)內(nèi)表1胃腸胰神經(jīng)內(nèi)分泌腫瘤的分級(jí)標(biāo)準(zhǔn)神經(jīng)內(nèi)分核分裂象數(shù)K567陽(yáng)性大細(xì)分級(jí)(IOHPF指數(shù)(%)小細(xì)Gl,低級(jí)別混合性C2,中級(jí)別C3,高級(jí)別>20部位特注:10HPF=2m2(視野直徑D50m,單個(gè)視野面積0196mm2),于核分裂活躍風(fēng)至少計(jì)數(shù)50個(gè)高倍視野;用MB1抗體在核標(biāo)記最強(qiáng)的區(qū)域計(jì)數(shù)500~2000個(gè)細(xì)胞的陽(yáng)性百分比TheFirstAffiliatedHospitalofZhengzhouUniversity·神經(jīng)內(nèi)分泌腫瘤(NET的胚胎起源前腸腫瘤中腸腫瘤后腸腫瘤中腸升結(jié)腸遠(yuǎn)端大腸1.ModlinIM,ObergK,ChungDC,etal.LancetOncol,2008;9:61-72.2.ModlinIM,KiddM,Latichl,etal,Gastroenterology,2005:128:1717-1751.sidelinesinOncology.V1,2008,FebrDS,ModlinIM,AdsayNV,etal,Am/SunTheFirstAffiliatedHospitalofZhengzhouUniversity主要的腫瘤部位2消化系統(tǒng)(289膚腺(0.32)十二指腸空/回腸(0.67)盲場(chǎng)(0其他/未知?jiǎng)偽?0.15結(jié)腸(0.20)2000年美國(guó)人群每100,000人的年齡調(diào)整年發(fā)生率;來(lái)自SEER登記K.DaviesAH.Ardill.et2008:26:3063-3072.3.KufeDw,PollockRE,WeichselbaumRR,etal.edsHolland-FreiCancerMedicine,6thedHamilton(oN):BCTheFirstAffiliatedHospitalofZhengzhouUniversity歐美國(guó)家近年來(lái)消化道各部位NET發(fā)病率部位歐美國(guó)家(SEER為主)0.30/100000/年十二指腸0.19/100000/年空回腸0.670.81/100000/年0.15/100000/年結(jié)腸O.2/100000/年0.86/100O00/年我國(guó)目前無(wú)全面的統(tǒng)計(jì)信息,2012年郭林杰等匯總1954年至2011年國(guó)內(nèi)發(fā)表的所有相關(guān)文獻(xiàn),總結(jié)GEP-