胃肝样腺癌的MDT讨论

MDT discussion of hepatoid adenocarcinoma of the stomach

目的讨论胃肝样腺癌的临床表现、诊断和治疗。方法对四川大学华西医院于2017年10月收治的1例胃肝样腺癌患者在术前所进行的MDT(multi-disciplinary team)讨论进行总结,并复习文献,分析胃肝样腺癌的临床病理学特点。结果胃肝样腺癌的临床特点是常伴有早期肝转移和甲胎蛋白(AFP)明显升高,易误诊为原发性肝细胞癌。其病理组织学特点是,形态上具有肝癌样分化和腺癌样分化两种结构。结论胃肝样腺癌是胃腺癌的特殊类型,根治性手术是其主要治疗手段,但预后较差。

Objective To discuss the clinical manifestations, diagnosis, and treatment of hepatoid adenocarcinoma of the stomach. Methods By summarizing the multi-disciplinary team results of 1 patient with hepatoid adenocarcinoma of the stomach, who underwent surgery in West China Hospital in October 2017, as well as reviewing the related literatures, to explore the clinicopathological features of hepatoid adenocarcinoma of the stomach. Results The clinical features of hepatoid adenocarcinoma of the stomach were often accompanied by early liver metastasis and alpha fetoprotein （AFP） significantly increased, which were easily misdiagnosed as primary hepatocellular carcinoma. The histopathological features of hepatoid adenocarcinoma of the stomach were characterized by two structures： hepatocellular carcinoma and adenocarcinoma. Conclusion Hepatoid adenocarcinoma of the stomach is a special type of gastric adenocarcinoma, and radical operation is the main treatment, but the prognosis of it is poor.