胃底腺型腺癌临床及病理特征分析

Clinical and pathological characteristics of gastric adenocarcinoma of fundic gland type

分析2019年1月至2022年7月浙江大学医学院附属邵逸夫医院、浙江省台州医院诊治的18例胃底腺型腺癌的临床、内镜和病理学特征。18例胃底腺型腺癌患者中,12例男性,6例女性,年龄38~78岁,平均年龄60.5岁,胃镜检查在胃底、体部表现为隆起型或扁平型病灶,大小0.2~5.5 cm,黏膜表面光滑、发红或粗糙。病理检查示以主细胞为主,散在少量壁细胞,构成相互吻合的复杂腺体,浸润至黏膜下层,免疫组织化学显示肿瘤细胞表达黏蛋白6(MUC6)和胃蛋白酶原-1,部分表达synaptophysin(Syn)。胃底腺型腺癌是一种分化好的罕见胃腺癌类型,仅有少部分病例被报道且目前对其认识不足,容易误诊或漏诊;掌握其临床和病理学特征,提高临床病理医师的诊断及鉴别诊断能力。

To analyze the clinical,endoscopic and pathological feature of gastric adenocarcinoma of fundic gland type(GA-FG)(18 cases)collected from Sir Run Run Shaw Hospital,affiliated with Zhejiang University School of Medicine and Taizhou Hospital of Zhejiang Province from January 2019 to July 2022.There were 18 cases of patient of GA-FG,including male 12 cases,female 6 cases,aged from 38 to 78 years old,with average age of 60.5 years old.Gastroscopy showed that bulging or flat lesions of gastric fundus were 0.2-5.5 cm in size,and the mucosal surface was smooth,redness or rough.Histologic examination showed that tumor cells were dominated by chief cells and scattered with a few oxyntic cells,formed a complex gland that anastomoses each other,and infiltrated to the submucosa.The results of immunohistochemistry showed that tumor cells were positive for the expression of mucin-6(MUC6)and Pepsinogen 1,and partial expression of synaptophysin(Syn).GA-FG is a rare type of gastric adenocarcinoma with good differentiation,and currently only a few cases have been reported,and often easily been misdiagnosed or missed.Therefore,to master the characteristics of clinic and pathology is helpful to improve the ability of clinical pathologists in differential diagnosis.