대장과 직장의 신경내분비암종 = Neuroendocrine Carcinoma of the Colon and Rectum

다국어 초록 (Multilingual Abstract)

Purpose: The aim of this study was to review our experience with neuroendocrine carcinoma (NEC) of the colon and rectum
to highlight the clinical and pathological characteristics in this relatively uncommon malignancy.
Methods: From December 1995 to December 2006, 11 patients with NEC were identified from our database of 6,143 colorectal
cancer patients (0.18%), which does not include carcinoid tumors. The pathology was retrospectively reviewed and
the tumors were categorized as pure NEC, including well-differentiated NEC (n=3), poorly-differentiated (n=3) and mixed
endocrine/ exocrine tumor (n=5) on the basis of the histology and immunohistochemical findings.
Results: The mean age of the patients was 57 yr (range, 37 to 69 yr). The tumors were located as follows: 8 in the colon and 3
in the rectum. The diagnosis of NEC was suggested preoperatively from the tissue biopsy in 2 of 9 patients (22.2%). The
tumors were advanced at the time of diagnosis, with American Joint Committee on Cancer Stage III (n=7) and Stage IV
disease (n=4). Most tumors stained positive by immunohistochemistry for neuroendocrine markers, including synaptophysin
(7/9, 77.8%); however, chromogranin was expressed in 4 of 9 NEC tumors (44.4%). Metastatic disease was detected at
the time of diagnosis in 36.4% (4/11) of the patients. The median survival for NEC was 16 mo (3.6-67.4 mo), and for pure
NEC and mixed endocrine/exocrine tumor was 4.1 mo and 23.6 mo, respectively.
Conclusion: NEC had distinctive cytoarchitectural features and was often immunoreactive for neuroendocrine markers. Our
findings showed that pure NEC had aggressive behavior and a poor prognosis.

다국어 초록 (Multilingual Abstract)

Purpose: The aim of this study was to review our experience with neuroendocrine carcinoma (NEC) of the colon and rectum
to highlight the clinical and pathological characteristics in this relatively uncommon malignancy.
Methods: From December 1995 to December 2006, 11 patients with NEC were identified from our database of 6,143 colorectal
cancer patients (0.18%), which does not include carcinoid tumors. The pathology was retrospectively reviewed and
the tumors were categorized as pure NEC, including well-differentiated NEC (n=3), poorly-differentiated (n=3) and mixed
endocrine/ exocrine tumor (n=5) on the basis of the histology and immunohistochemical findings.
Results: The mean age of the patients was 57 yr (range, 37 to 69 yr). The tumors were located as follows: 8 in the colon and 3
in the rectum. The diagnosis of NEC was suggested preoperatively from the tissue biopsy in 2 of 9 patients (22.2%). The
tumors were advanced at the time of diagnosis, with American Joint Committee on Cancer Stage III (n=7) and Stage IV
disease (n=4). Most tumors stained positive by immunohistochemistry for neuroendocrine markers, including synaptophysin
(7/9, 77.8%); however, chromogranin was expressed in 4 of 9 NEC tumors (44.4%). Metastatic disease was detected at
the time of diagnosis in 36.4% (4/11) of the patients. The median survival for NEC was 16 mo (3.6-67.4 mo), and for pure
NEC and mixed endocrine/exocrine tumor was 4.1 mo and 23.6 mo, respectively.
Conclusion: NEC had distinctive cytoarchitectural features and was often immunoreactive for neuroendocrine markers. Our
findings showed that pure NEC had aggressive behavior and a poor prognosis.

참고문헌 (Reference)

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