胃肝样腺癌9例报道及文献复习

Hepatoid adenocarcinoma of stomach: clinical and pathologic analysis and review of literature

目的 :探讨胃肝样腺癌(adenocarcinoma of stomach,HAS)患者的临床病理特征,以提高医师对该病的认识及诊断水平。方法:分析9例HAS患者的临床表现、病理形态特征及免疫组织化学检测结果,并结合文献进行探讨。结果:9例HAS患者中,8例为男性,1例女性;平均为(64±10)岁,临床主要表现为上腹部隐痛、黑便或进餐时呕吐。8例患者术前行血清甲胎蛋白(α-fetoprotein,AFP)检测,其中6例升高。病理检查结果显示,HAS在组织形态学上具有肝细胞癌的分化特征,而免疫组织化学检测显示存在不同程度的AFP表达。结论:HAS罕见,且易发生淋巴结及肝脏转移,及早诊断有助于改善患者的临床预后。

Objective： To study the clinicopathologic characteristics of hepatoid adenocarcinoma（HAS） of stomach for improving the recognition and diagnosis of HAS. Methods： A total of 9 patients with HAS of stomach were enrolled. Clinical symptoms, pathological characteristics and immunohistochemical staining of lesions were analyzed and relevant literatures were reviewed. Result： Of these 9 patients, the mean age was（64±10） years, and 8 patients were male. Serum AFP was increased in 6 cases. The major clinical manifestations were abdominal pain, melena or vomiting. Pathological examination revealed that HAS had histological differentiation characteristics of hepatocellular carcinoma. The tumor cells were immunohistochemially positive for AFP in various degree. Conclusions： HAS is a rare tumor which is prone to lymph node and liver metastases. Early detection and differentiation of HAS by histopathology may improve the clinical prognosis.