胃肝样腺癌的临床病理特征

Clinicopathologic features of hepatoid adenocarcinoma of the stomach

目的探讨胃肝样腺癌(hepatoid adenocarcinoma of the stomach,HAS)的临床病理学特点、发生机制和免疫组化特征,以提高诊断水平。方法收集并分析5例胃肝样腺癌的临床特征和病理资料,采用HE染色、免疫组化方法,并复习文献。结果组织学胃肝样腺癌具有管状腺癌、粘液性癌和肝样分化腺癌的移行过渡,肿瘤细胞呈小梁状、巢团状,间质为丰富的血窦。免疫表型胃肝样腺癌AAT(5/5)、ACT(5/5)、CEA(5/5)、AFP(4/5)均为阳性,Hep par 1灶性阳性(2/5)。结论胃肝样腺癌是一种少见的高度恶性、侵袭性强的特殊类型胃癌,组织学呈肝细胞样腺癌,免疫表型AFP、AAT和ACT阳性有助诊断。

Objective To investigate the clinicopathological features of hepatoid adenocarcinoma of the stomach （HAS） for improvement of its diagnosis. Methods Five cases of HAS were studied using routine histopathology （HE staining）, and immunohistochemistry. Clinicopathological characteristics were then described with literature review. Results Under microscope, the tumor consisted of tubular adenocarcinoma, mucoid adenocarcinoma and hepatoid differentiated adenocarcinoma~ and cancer cells were arranged in a solid or trabecular pattern, separated by plentiful sinusoid-like blood vessels. Immuno- histochemically, the tumor was positive for AAT（5/5）, ACT （5/5）, CEA （5/5）, AFP （4/5）, and 2 cases were handfully positive for Hep par 1. Conclusion HAS is a rare gastric carcinoma with highly malignant and more aggressive behaviour. Additionally, the tumor typically has a characteristic appearance by microscopic observation and immunohistochemical phenotype.