胃肝样腺癌9例并文献复习

Gastric Hepatoid Adenocarcinoma:9 Cases Report and Review of the Literature

目的探讨胃肝样腺癌的病理形态和临床特点。方法回顾性分析2005年1月至2012年1月崇阳县人民医院收治的9例胃肝样腺癌患者的临床资料。结果 9例患者临床表现以上腹部疼痛、腹胀、黑便等消化道症状为主;血清甲胎蛋白(AFP)含量异常持续增高(92.34～1 984.03 ng/ml),阳性率为77.78%(7/9);B超或CT检出伴有肝转移者为33.33%(3/9):该病以胃窦部多发,占66.67%(6/9),病理类型多为溃疡型(77.78%,7/9);胃癌组织内出现肝细胞癌样分化区是其特有的病理形态,9例患者平均存活19个月。结论胃肝样腺癌具有独特的病理形态和临床特点,血清AFP阳性,发病年龄高,易转移,治疗及预后较其他胃腺癌差,应引起临床医师足够重视。

Objective To investigate histological characteristics and clinical featuers of gastric hepatoid adenocarcino- ma. Methods 9 patients with gastric hepatoid adenocarcinoma （GHAC） were evaluated for histology and clinical data from January 2005 to January 2012 in renmin hospital of Chongyang. Results In the 9 cases,the main clinical manifestations were upper abdominal pain, distension, melena and other gastrointestinal symptems ; Serum alpha- fetoprotein （ AFP ） levels were high level（92.34 - 1984.03 ng/ml） with a positive rate of 77.78%. The percentage of liver metastasis detected by US-B or CT was 33.33 % （3/9）, and mostly seen at the gastric sinus （ 66.67 %, 6/9 ）. The pathologic type was mostly anabrosis （ 77.78 %, 7/ 9）. Hepatocellular carcinoma- like differentiation zone is a unique pathological in GHAC. The average time of survival of 9 pa- tients was 19 months. Conclusion GHAC has its own histological characteristics and clinical features, such as positive AFP levels, higher incidence of in the elderly, aggressive, poor prognosis, which should be received much concern by clinicians.