What Are the Different Types of Endocrine Cancer?

Neuroendocrine cancer is a cancer with endocrine function. Often divided into large cell neuroendocrine cancer, carcinoid, atypical carcinoid, small cell carcinoma. Carcinoids are the best, generally resection is sufficient, and the rate of metastasis and recurrence is low. Small cell carcinoma is highly malignant and progresses rapidly. Atypical carcinoids are equivalent to the cancers we often say. Large-cell carcinoma is also highly malignant.

Neuroendocrine cancer

Introduction to Neuroendocrine Cancer

Gastrointestinal neuroendocrine carcinoma

Respiratory endocrine carcinoma

Classification of neuroendocrine cancer

Gastrointestinal neuroendocrine cancer includes carcinoid and small cell neuroendocrine cancer.

Microscopic features of neuroendocrine cancer

It usually manifests as a submucosal tumor, with the surface mucosa bulging or the formation of ulcers. The cut surface is gray-yellow with no envelope. Tumor cells are composed of more consistent small to medium-sized cancer cells, with unclear cytoplasmic boundaries, round and regular nuclei, arranged in slices, cords, clusters, adenoids, or daisy-like clusters. Poorly differentiated, the cancer cells are smaller, the cytoplasm is less, the nucleus is often angular, deeply stained, and has a split image. Under electron microscope, neuroendocrine particles with a diameter of 200-300nm can be seen.

Neuroendocrine cancer diagnosis

Endoscopy and pathological examination, 24-h urine 5-HIAA (metabolite of serotonin) is helpful for diagnosis; determination of immunohistochemical detection has special diagnostic value, and generally can be used to display neuroendocrine markers NSE, CHG2A, synapses Vesicle protein (Sy), etc.

Differential diagnosis of neuroendocrine cancer

Gastrointestinal neuroendocrine cancer should be distinguished from poorly differentiated adenocarcinoma. Immunohistochemistry is positive for NSE and CHG2A, and it can be a neuroendocrine tumor. CEA-negative and Gas-negative can exclude poorly differentiated adenocarcinoma and gastrinoma, respectively. Combining gross, tissue morphology and clinically highly malignant biological behavior, it can diagnose gastric neuroendocrine cancer.

Neuroendocrine Cancer Treatment

Gastrointestinal neuroendocrine cancer is mainly treated by surgery. The scope of the operation depends on the size, location, degree of invasion, lymph node involvement, and whether the liver is metastatic. During the operation, we should carefully explore whether there are multiple lesions or other tumors. According to the literature on the biological characteristics of gastrointestinal neuroendocrine cancer, it is generally believed that the principles of surgical treatment are: tumors less than 2 cm in diameter, unsoaked and muscular layers, and gastric, appendix, and rectal carcinoids without lymph node metastasis can be used locally Resection; radical surgery is required for small intestine, colon carcinoids or tumors larger than 2 cm, infiltrated muscularis, and carcinoids with lymph node metastasis; metastatic carcinoids, if systemic conditions allow, palliative primary lesions and metastases are feasible Excision of the foci.

Based on the above principles, different surgical methods are used for gastrointestinal carcinoids. The range of resection of multifocal and mixed carcinoid and small cell neuroendocrine cancer should be appropriately expanded. The surgical method is the same as that of digestive tract adenocarcinoma.

Prognosis of neuroendocrine cancer

The prognosis of gastrointestinal carcinoid tumors is generally better than that of adenocarcinomas. Those with a diameter of less than 2 cm are similar to the prognosis of benign tumors. Those with a diameter greater than 2 cm or with lymph node metastasis have a poorer prognosis; multifocal or mixed carcinoids and small cells The prognosis of neuroendocrine cancer is even worse. Attention should be paid to the postoperative follow-up of this disease. During the follow-up, for patients with a high degree of malignancy, liver B ultrasound, CT, etc. should be regularly reviewed, and the concentration of metabolites in urine (52HIAA, etc.) of biogenic amines and peptides should be dynamically detected. Sexually supplemented with chemotherapy, biological treatment and other comprehensive treatment measures to improve survival rate.