胃肝样腺癌临床病理、免疫表型及预后分析

Clinicopathology,Immunophenotype and Prognosis of Gastric Hepatoid Adenocarcinoma

目的研究和分析胃肝样腺癌临床病理、免疫表型和预后特点.方法收集 2 0 0 6年 3 月-2 0 1 6年 3 月入院治疗的 10 例胃肝样腺癌患者的临床资料,分析病理特点和诊断治疗.结果 1 0 例患者治疗前检查血清均明显增高, A F P呈阳性;均 有淋巴结转移;病变临床表现为溃疡或溃疡型肿物、低分化或中低分化腺癌伴部分肝样腺癌.其中,有 3 例患者的腺癌位于 胃窦部, 4 例于胃体部, 3 例位于贲门部 ;2 例患者癌细胞向卵巢转移, 4 例向肝脏转移, 4 例伴胃周淋巴结转移.4 例患者没 进行手术, 6 例患者进行手术切除,其中 4 例患者做根治性手术,同时采用不同的疗程进行全身化疗和介入化疗;患者总体 预后差,死亡 4 例,其生存期为 1- 9 个月.结论胃肝样腺癌是一类容易向淋巴结和肝脏及器官组织发生转移的特殊胃癌, 预后差,临床治疗效果差,应该予以重视.

Objective To investigate the clinical pathology, immunophenotype and prognosis of Gastric hepatoid adeno-carcinoma. Methods A total of 10 patients with Gastric hepatoid adenocarcinoma were enrolled in this study from March 2006 to March 2016. The pathological features, diagnosis and treatment were investigated. The serum level of 10 patientssignificantly increased before treatment, and the AFP was positive. All subjects had lymph node metastasis. The clinical fea-tures were ulcer or ulcer type of tumor, poorly differentiated or poorly differentiated adenocarcinoma with hepatoid adenocar-cinoma. There were 3 cases located in gastric antrum, 4 cases in stomach, and 3 cases in cardia. There were 2 cases with ovari-an metastasis, 4 cases with liver metastasis, and 4 cases with gastric lymph node metastasis. Among 10 patients, 4 cases were without surgery, 6 cases underwent surgical resection and 4 of 6 were treated with radical surgery combined with systemic chemotherapy and interventional chemotherapy. All subjects were with poor prognosis, the survival period of 1 to 9 months. Conclusion Gastric hepatoid adenocarcinoma is a special gastric cancer with lymph node and liver metastasis, with a poor prognosis and clinical effect.