44例EBV相关性胃癌临床病理分析

To investigate the pathological features of EBV-associated gastric cancer

目的:讨论EBV相关性胃癌(EBVaGC)的病理特征。方法:回顾44例手术治疗的诊断EBV相关性胃癌病理切片,分析临床病理学特征、免疫组化、原位杂交检测结果,结合相关参考文献进行分析讨论。结果:44例EBV相关性胃癌患者中男性32例,女性12例,年龄31~85岁。病理特征为肿瘤细胞排列成条索状、巢片状结构,部分可见小的腺腔样结构,间质有大量淋巴样细胞浸润。免疫组化染色显示CKpan肿瘤细胞浆阳性,32例CK8&18肿瘤细胞浆阳性,12例CK7肿瘤细胞浆阳性,12例LCA相应细胞膜阳性,5例Syn和CgA肿瘤细胞浆阳性,原位杂交44例EB病毒早期RNA(EBER)肿瘤细胞核阳性。随访1到5年,40例无瘤存活,3例死亡,1例失访。结论:EBV相关性胃癌具有独特的临床病理学特征,以男性为主,诊断的金标准为EBER-ISH检测,预后较好。

Objective:To investigate the pathological features of EBV-associated gastric cancer(EBVaGC).Methods:A retrospective study was performed on 44 patients with EBV-associated gastric cancer.The clinicopathological features,immunohistochemistry,in situ hybridization results,and related references were analyzed.Results:Of the 44 patients with EBV-associated gastric cancer,32 were male and 12 were female,aged 31~85 years.The pathological feature is that the tumor cells are arranged in a strip-like shape,a nest-like structure,and some small glandular structures are seen,and a large amount of lymphoid cells infiltrate in the interstitium.Immunohistochemistry showed CKpan(+),32 cases of CK8&18(+),12 cases of CK7(+),12 cases of LCA corresponding(+),5 cases of Syn and chrome A scattered(+),in situ hybridization of 44 cases of EBER(+).After 1 to 5 years of follow-up,40 patients survived without tumor,3 died,and 1 was lost to follow-up.Conclusion:EBV-associated gastric cancer has unique clinicopathological features,especially in male.The gold standard for diagnosis is EBER-ISH,and the prognosis is good.