ECL cell tumor and poorly differentiated endocrine carcinoma of the stomach: Prognostic evaluation by pathological analysis

被引:259
作者
Rindi, G
Azzoni, C
La Rosa, S
Klersy, C
Paolotti, D
Rappel, S
Stolte, M
Capella, C
Bordi, C
Solcia, E
机构
[1] Univ Pavia, Dept Human Pathol, I-27100 Pavia, Italy
[2] IRCCS, Ist Ricovero & Cura Carattere Sci, Policlin San Matteo, Pavia, Italy
[3] Univ Parma, Inst Pathol Anat, I-43100 Parma, Italy
[4] Univ Pavia, Dept Pathol, Varese, Italy
[5] IRCCS, Policlin San Matteo, Biometr Unit, Pavia, Italy
[6] Klinikum Bayreuth, Inst Pathol, Bayreuth, Germany
[7] Univ Erlangen Nurnberg, Nurnberg, Germany
关键词
D O I
10.1016/S0016-5085(99)70174-5
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background & Pims: Gastric endocrine tumors show a wide spectrum of clinical behavior, and prognostic assessement of individual tumors is difficult. The aims of this work were to identify predictors of tumor malignancy and patient outcome. and to provide a rationale for treatment; guidelines. Methods: Gastric endocrine tumors (86 enterochromaffin-like cell carcinoids and 16 poorly differentiated carcinomas) were. investigated for 15 clinicopathologic variables and for expression of Ki67, P53, and BCL-2 proteins. Data were analyzed by univariate and multivariate statistics far evidence of tumor malignancy and patient survival. Results: Histological grades 2 and 3, size greater than or equal to 3 cm, 9 or move mitoses, or greater than or equal to 300 Ki67-positive cells per 10 high-power fields identified 26 of 33 (79%) malignant (metastatic or deeply invasive) tumors, and size <1 cm and/or growth restricted to the mucosa characterized 46 of 69 (67%) tumors with benign behavior during a median follow-up of 39 months. Malignancy-predictive models were developed using angioinvasion, size, clinicopathologic type, mitotic index, and Ki67 index. The same variables, in addition to deep gastric wall invasion and histological grade, predicted patient outcome. Conclusions: Criteria for the assessment of malignancy risk and patient outcome were developed for the different tumors, providing a basis for treatment guidelines.
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页码:532 / 542
页数:11
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