Endocrine cell tumor of the gastrointestinal tract : characteristics and racial differences

1.新型内分泌细胞Ghrelin细胞与胃类癌（1）Ghrelin和ECL细胞在无肠化的普通慢性胃炎胃底粘膜中分布最密集，是胃底粘膜中主要的内分泌细胞类型。它们的增加和减少与粘膜状况和内分泌因素如胃泌素有关。（2）ECL和Ghrelin细胞均表现为慢性自身免疫性胃炎胃底粘膜腺内外内分泌细胞增生和类癌形成。形成类癌的主要细胞类型是ECL细胞。（3）正常慢性胃炎和自身免疫性慢性胃炎的类癌均由ECL细胞和Ghrelin细胞组成。胃、大肠内分泌细胞癌（1）内分泌细胞癌在多种内分泌细胞标志物上表现出多样性。胃肠道粘蛋白表型共表达（67%）、Musashi-1蛋白表达（67%）、p53蛋白过表达（75%）、Ki-67阳性细胞比例高（50-60%）。（2）内分泌细胞癌具有内分泌多分化和粘蛋白核心蛋白表达、自我复制和高度增殖的特点。（3）“多分化、低分化癌细胞”的性质与胃肠道内分泌细胞癌的高恶性度有关。（3）日本与西方胃肠道内分泌细胞肿瘤分类系统的差异（1）本研究首次阐明了两种分类系统的细节差异及其存在的问题。

1.Novel endocrine cells "ghrelin cells" and carcinoid tumor of the stomach(1)Ghrelin and ECL cells were distributed most densely in the gastric fundic mucosa without intestinal metaplasia of ordinary chronic gastritis, and were the major endocrine cell type there. Their increase and decrease were related to the mucosal condition and endocrinological factors such as gastrin.(2)Both ECL and ghrelin cells showed intra-and extra-glandular endocrine cell byperplasia and carcinoid tumor formation in the fimdic mucosa of auto-immune chronic gastritis. The main cell type forming carcinoid tumor was ECL cells.(3)Carcinoid tumors in the ordinary chronic gastritis and in autoimmune chronic gastritis were composed commonly of ECL cells and ghrelin cells. However, carcinoid tumors in the latter were formed with association of endocrine cell hyperplasia, and those in the former were formed without association of endocrine cell hyperplasia.2.Endocrine cell carcinoma of the stomach and large intestine(1)Endocrine cell carcinomas showed diversity in kinds of endocrine cell markers. They frequently showed co-expression of gastric and intestinal mucin phenotypes (67%), expression of musashi-1 protein (67%), over-expression of p53 protein (75%), and high incidence of Ki 67 positive cells (50-60%).(2)Endocrine cell carcinomas were characterized by multi-differentiation both to endocrine nature and mucin core protein expression, self-replication, and high proliferation.(3)The nature of "multi-differentiated, poorly differentiated carcinoma cells" was related to the high malignancy of the endocrine cell carcinomas of the gastrointestinal tract.3.Difference between Japanese and Western classification systems for endocrine cell tumors of the gastrointestinal tract(1)The detail differences of both classification systems and their problems for settling were first demonstrated in this study.