北京大学学报(医学版) ›› 2023, Vol. 55 ›› Issue (2): 210-216. doi: 10.19723/j.issn.1671-167X.2023.02.003

• 专家笔谈 • 上一篇    下一篇

弥漫性神经内分泌细胞肿瘤病理学:共性与异质性

张波*()   

  • 收稿日期:2022-10-17 出版日期:2023-04-18 发布日期:2023-04-12
  • 通讯作者: 张波 E-mail:zhangbo@bjmu.edu.cn

波 张*()   

  • Received:2022-10-17 Online:2023-04-18 Published:2023-04-12
  • Contact: 波 张 E-mail:zhangbo@bjmu.edu.cn

RICH HTML

  

关键词: 神经内分泌细胞, 神经内分泌肿瘤, 分型, 分级, 生物标志物

中图分类号: 

  • R739.4

图1

神经内分泌细胞及肿瘤分子标志物"

图2

神经内分泌细胞类群及肿瘤"

表1

神经内分泌肿瘤代表性分级系统"

神经内分泌肿瘤 分级 诊断标准
胃肠、胰腺、胆道
  NET NET, G1 < 2 mitoses/2 mm2和/或Ki-67 < 3%
NET, G2 2~20 mitoses/2 mm2和/或Ki-67 3%~20%
NET, G3,无NEC组织学特点 >20 mitoses/2 mm2和/或Ki-67>20%
  NEC Small cell NEC(小细胞特征) >20 mitoses/2 mm2和/或Ki-67>20% (often>70%), 小细胞特征
Large cell NEC(大细胞特征) >20 mitoses/2 mm2和/或Ki-67>20% (often>70%), 大细胞特征
上呼吸道、涎腺
  NET NET, G1 < 2 mitoses/2 mm2,无坏死, Ki-67 < 20%
NET, G2 2~10 mitoses/2 mm2和/或坏死,Ki-67 < 20%
NET, G3,无NEC组织学特点 >10 mitoses/2 mm2和/或Ki-67>20%
  NEC Small cell NEC(小细胞特征) >10 mitoses/2 mm2和/或Ki-67>20% (often>70%)
Large cell NEC(大细胞特征) >10 mitoses/2 mm2,和/或Ki-67>20% (often>55%)
肺、胸腺
  NET 典型类癌/NET, G1 < 2 mitoses/2 mm2,无坏死
非典型类癌/NET, G2 2~10 mitoses/2 mm2,坏死(点状)
  NEC Small cell (lung) carcinoma(小细胞特征) >10 mitoses/2 mm2, 坏死,Ki-67(often>70%),小细胞特征
Large cell NEC(大细胞特征)
*具有高增殖活性非典型类癌
>10 mitoses/2 mm2, 坏死,Ki-67>20%(often>40%),大细胞特征
*非典型类癌组织学,higher (>10 mitoses/2 mm2)
mitotic count和/或higher (>30%) Ki-67

图3

基于SSTR表达的临床诊断和治疗策略"

1 Modlin IM , Champaneria MC , Bornschein J , et al. Evolution of the diffuse neuroendo crine system: Clear cells and cloudy origins[J]. Neuroendocrinology, 2006, 84 (2): 69- 82.
doi: 10.1159/000096997
2 Andersson-Rolf A, Clevers H, Dayton TL. Diffuse hormonal systems[M]. South Dartmouth (MA): MDText. com, Inc., 2000: 25905254[2022-10-01]. http://www.endotext.org/.
3 Rindi G , Mete O , Uccella S , et al. Overview of the 2022 who classification of neuroendocrine neoplasms[J]. Endocr Pathol, 2022, 33 (1): 115- 154.
doi: 10.1007/s12022-022-09708-2
4 Ahmed M . Gastrointestinal neuroendocrine tumors in 2020[J]. World J Gastrointest Oncol, 2020, 12 (8): 791- 807.
doi: 10.4251/wjgo.v12.i8.791
5 Asa SL , La Rosa S , Basturk O , et al. Molecular pathology of well-differentiated gastro-entero-pancreatic neuroendocrine tumors[J]. Endocr Pathol, 2021, 32 (1): 169- 191.
doi: 10.1007/s12022-021-09662-5
6 Metovic J , Bianchi F , Rossi G , et al. Recent advances and current controversies in lung neuroendocrine neoplasms[J]. Semin Diagn Pathol, 2021, 38 (5): 90- 97.
doi: 10.1053/j.semdp.2021.03.002
7 Couvelard A , Cros J . An update on the development of concepts, diagnostic criteria, and challenging issues for neuroendocrine neoplasms across different digestive organs[J]. Virchows Arch, 2022, 480 (6): 1129- 1148.
doi: 10.1007/s00428-022-03306-7
8 Ahadi M , Sokolova A , Brown I , et al. The 2019 World Health Organization classification of appendiceal, colorectal and anal canal tumours: An update and critical assessment[J]. Pathology, 2021, 53 (4): 454- 461.
doi: 10.1016/j.pathol.2020.10.010
9 Zhang Y , Nosé V . Endocrine tumors as part of inherited tumor syndromes[J]. Adv Anat Pathol, 2011, 18 (3): 206- 218.
doi: 10.1097/PAP.0b013e3182169916
10 Nosé V , Gill A , Teijeiro JMC , et al. Overview of the 2022 who classification of familial endocrine tumor syndromes[J]. Endocr Pathol, 2022, 33 (1): 197- 227.
doi: 10.1007/s12022-022-09705-5
11 Metovic J , Barella M , Bianchi F , et al. Morphologic and molecular classification of lung neuroendocrine neoplasms[J]. Virchows Arch, 2021, 478 (1): 5- 19.
doi: 10.1007/s00428-020-03015-z
12 Dinter H , Bohnenberger H , Beck J , et al. Molecular classification of neuroendocrine tumors of the thymus[J]. J Thorac Oncol, 2019, 14 (8): 1472- 1483.
doi: 10.1016/j.jtho.2019.04.015
13 Asa SL , Erickson LA , Mete O . The next steps for endocrine pathology[J]. Endocr Pathol, 2022, 33 (1): 228- 230.
doi: 10.1007/s12022-022-09711-7
14 Hamie L , Abbas O , Bhawan J . Neuroendocrine differentiation of skin tumors: A comprehensive review[J]. Am J Dermatopathol, 2020, 42 (12): 899- 910.
doi: 10.1097/DAD.0000000000001664
15 La Rosa S , Uccella S , Molinari F , et al. Mixed adenoma well-differentiated neuroendocrine tumor (manet) of the digestive system: An indolent subtype of mixed neuroendocrine-nonneuroendocrine neoplasm (MiNEN)[J]. Am J Surg Pathol, 2018, 42 (11): 1503- 1512.
doi: 10.1097/PAS.0000000000001123
16 Kövári B , Turkevi-Nagy S , Lauwers GY , et al. mixed intraepithelial neoplasia-well-differentiated neuroendocrine tumor of the gallbladder: A hitherto unreported combination[J]. Int J Surg Pathol, 2021, 29 (6): 685- 689.
doi: 10.1177/1066896920986987
17 Bell PD , Pai RK . Goblet cell adenocarcinoma of the appendix: An update and practical approach to diagnosis and grading[J]. Hum Pathol, 2023, 132, 183- 196.
doi: 10.1016/j.humpath.2022.06.002
18 Günther T , Tulipano G , Dournaud P , et al. Somatostatin receptors: Structure, function, ligands, and new nomenclature[J]. Pharmacol Rev, 2018, 70 (4): 763- 835.
doi: 10.1124/pr.117.015388
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