胃肝样腺癌CT及临床表现

CT and clinical manifestations of hepatoid adenocarcinoma of stomach

目的观察胃肝样腺癌(HAS)CT及临床表现。方法收集30例经术后病理确诊的HAS患者(HAS组)及30例术后病理确诊为非HAS的胃腺癌(GA)患者(非HAS组);对比观察2组CT及临床表现。结果2组患者性别、年龄、病程及主要症状差异均无统计学意义(P均>0.05)。肿瘤标志物检查显示,HAS组17例(56.67%,17/30)血清甲胎蛋白(AFP)升高。HAS组病灶最大径大于、而CT值;小于非HAS组(P均<0.05),且组间强化程度及强化方式差异均有统计学意义(P均<0.05)。HAS组转移淋巴结短径及术后转移率均高于非HAS组(P均<0.05),而肿瘤分化程度、患者中位无进展生存期及中位总生存期均低于非HAS组(P均<0.05)。结论HAS临床表现不典型,患者多伴血清AFP升高,预后较差;其CT表现具有一定特征性,可据以与非HAS GA相鉴别。

Objective To observe CT and clinical manifestations of hepatoid adenocarcinoma of stomach(HAS).Methods Totally 30 patients with HAS(HAS group)and 30 with non-HAS gastric adenocarcinoma(GA,non-HAS group)confirmed by postoperative pathology were enrolled.CT and clinical manifestations were observed and compared between groups.Results Tumor marker examination showed 17 cases(56.67%,17/30)in HAS group with increased serum alpha fetal protein(AFP)level.There was no significant difference of patients’gender,age,course of disease and main symptoms between groups(all P>0.05).The maximum diameter of lesions in HAS group was larger than that in non-HAS group,while the difference of CT value of lesions between venous phase and arterial phase in HAS group was smaller than that in non-HAS group(both P<0.05),and the enhancement degrees and modes were significantly different between groups(both P<0.05).The short diameter of metastatic lymph nodes and postoperative metastasis rate in HAS group were higher than those in non-HAS group(both P<0.05),while the tumor differentiation degree,the patients’median progression free survival and median overall survival in HAS group all lower than those in non-HAS group(all P<0.05).Conclusion HAS had atypical clinical manifestations,with elevated serum AFP and poor prognosis.CT manifestations of HAS were of certain characteristics,which could be used to distinguish HAS from non-HAS GA.