含有透明细胞胃癌的临床病理研究

A Clinicopathologic Study on Gastric Carcinoma with Gear Cell

目的:探讨含有透明细胞胃癌的临床病理意义。方法:26例含有透明细胞胃癌手术标本分别进行光镜、电镜观察及组织化学、ABC法免疫组化染色。2例妊娠3月胎儿胃肠标本作对照。结果:含有透明细胞胃癌均为进展期癌,组织学主要有2种类型:不同分化程度的乳头状管状腺癌及肝样腺癌,18例(76.92％)见淋巴管癌栓,5例(19.23％)见静脉癌栓;淋巴结及肝转移率高(88.46％,11.54％),5年生存率为9.1％。透明细胞AB染色阴性,PAS染色少部分阳性。电镜见胞质中含有丰富的糖原颗粒。AFP、AAT和HCG阳性率分别为64.71％、76.47％和58.82％。结论::含有透明细胞胃癌属于产生AFP并伴胎儿肠胚分化腺癌及肝样腺癌,恶性程度高,预后差。

Objective: To explore the significances of gastric carcinoma with clear cell. Methods: 26 cases resected samples of gastirc carcinoma with clear cell were evaluated with light, electron microscopic examination, histochemical and immunohisto -chemical methods.2 cases fetal gasteointestinal tract samples from 3 months gestation was used as controled. Results: Gastric carcino-ma with clear cell were all advanced stage carcinoma. There were two primarily histologic subtypes of vainous differentiation tubu -papillary and hepatoid adenocarcinomas. The tumor emboli were observed in lymphatic vessels of 18 cases( 76.92 % ) and in vein of 5 cases (19.23%). It was higher metastasis rates in lymph nodes (88.64 % ) and in liver ( 11.54 % ) . T he survivial rates of five years was only 9.10% . The clear cell were negatice reaction to AB staining and were part positive to PAS. Ultrastructurally, the cyto-plasm presented abundant glycogen granules. The positive rates of AFP, AAT and HCG were 64.71%, 76.47% and 58.82% re-spectively. Conclusion: Gastric carcinoma with clear cell are AFP- producing gastric cacinoma with enteroblastic differentiation or hepatoid adnocarcinoma. They are highly malignant tumors with poor prognosis.