胃肝样腺癌(hepatoid adenocarcinoma of the stomach,HAS)是一种表现在肝脏外的罕见的特殊胃恶性肿瘤,与一般的胃癌不同,HAS的恶性程度高、侵袭性高,容易出现肝转移、淋巴转移、预后差,但是HAS的诊断、临床病理特征和预后仍有较大的争...胃肝样腺癌(hepatoid adenocarcinoma of the stomach,HAS)是一种表现在肝脏外的罕见的特殊胃恶性肿瘤,与一般的胃癌不同,HAS的恶性程度高、侵袭性高,容易出现肝转移、淋巴转移、预后差,但是HAS的诊断、临床病理特征和预后仍有较大的争论.为了帮助临床医生更了解这种胃癌,本文从甲胎蛋白的起源开始对HAS的诊断、临床病理特征及其预后等进行系统综述,从而为这种特殊胃癌的临床诊治提供建设性的意见及帮助.展开更多
INTRODUCTIONGastric cancer is one of the most common fatal malignancies in the world. The prognosis is generally poor in advanced gastric cancer .The low survival is related to delayed diagnosis, metastasis and recurr...INTRODUCTIONGastric cancer is one of the most common fatal malignancies in the world. The prognosis is generally poor in advanced gastric cancer .The low survival is related to delayed diagnosis, metastasis and recurrence after operation .The aim of this paper was to find correlation between clinical factors was to find correlation between clinical factors and biologic behavior of gastric cancer in a series of 1200 patients undergoing surgical resection.展开更多
BACKGROUND Although pathological response is a common endpoint used to assess the efficacy of neoadjuvant chemotherapy (NAC) for gastric cancer, the problem of a low rate of concordance from evaluations among patholog...BACKGROUND Although pathological response is a common endpoint used to assess the efficacy of neoadjuvant chemotherapy (NAC) for gastric cancer, the problem of a low rate of concordance from evaluations among pathologists remains unresolved. Moreover, there is no globally accepted consensus regarding the optimal evaluation. A previous study based on a clinical trial suggested that pathological response measured using digitally captured virtual microscopic slides predicted patients’ survival well. However, the pathological concordance rate of this approach and its usefulness in clinical practice were unknown. AIM To investigate the prognostic utility of pathological response measured using digital microscopic slides in clinical practice. METHODS We retrospectively evaluated pathological specimens of gastric cancer patients who underwent NAC followed by surgery and achieved R0 resection between March 2009 and May 2015. Residual tumor area and primary tumor beds were measured in one captured image slide, which contained the largest diameter of the resected specimens. We classified patients with < 10% residual tumor relative to the primary tumorous area as responders, and the rest as non-responders;we then compared overall survival (OS) and relapse-free survival (RFS) between these two groups. Next, we compared the prognostic utility of this method using conventional Japanese criteria. RESULTS Fifty-four patients were evaluated. The concordance rate between two evaluators was 96.2%. Median RFS of 25 responders and 29 non-responders was not reached (NR) vs 18.2 mo [hazard ratio (HR)= 0.35, P = 0.023], and median OS was NR vs 40.7 mo (HR = 0.3, P = 0.016), respectively. This prognostic value was statistically significant even after adjustment for age, eastern cooperative oncology group performance status, macroscopic type, reason for NAC, and T- and Nclassification (HR = 0.23, P = 0.018). This result was also observed even in subgroup analyses for different macroscopic types (Borrmann type 4/non-type 4) and histological types (differentiated/undifferentiated). Moreover, the adjusted HR for OS between responders and non-responders was lower in this method than that in the conventional histological evaluation of Japanese Classification of Gastric Carcinoma criteria (0.23 vs 0.39, respectively). CONCLUSION The measurement of pathological response using digitally captured virtual microscopic slides may be useful in clinical practice.展开更多
Carcinosarcomas are rare,malignant,biphasic tumors. We report the case of a 62-year-old man with gastric carcinosarcoma,along with its clinical,macroscopic and histopathological features. Macroscopically,a specimen of...Carcinosarcomas are rare,malignant,biphasic tumors. We report the case of a 62-year-old man with gastric carcinosarcoma,along with its clinical,macroscopic and histopathological features. Macroscopically,a specimen of deformed stomach was obtained that measured 200 mm×150 mm×100 mm. A 150 mm×100 mm× 50 mm exophytic tumoral mass (Borrmann typeⅠ) was found,which involved the posterior wall from the cardia to the antrum. Histopathologically,a mixed type of malignancy was revealed: an adenocarcinoma with intestinal metaplasia,with interposed fascicles of fusiform atypical cells and numerous large,rounded and oval cells. The tumor showed positive histochemistry for cytokeratin 18,epithelial membrane antigen,carcinoembryonic antigen,chromogranin A and vimentin. Liver metastases were diagnosed 8 mo postoperatively,and the patient died 4 mo later. A review of the available literature is also presented.展开更多
AIM: To evaluate the clinical and endoscopic patterns in a large series of patients with metastatic tumors in the stomach. METHODS: A total of 64 patients with gastric meta- stases from solid malignant tumors were ret...AIM: To evaluate the clinical and endoscopic patterns in a large series of patients with metastatic tumors in the stomach. METHODS: A total of 64 patients with gastric meta- stases from solid malignant tumors were retros- pectively examined between 1990 and 2005. The clinicopathological findings were reviewed along with tumor characteristics such as endoscopic pattern, location, size and origin of the primary sites. RESULTS: Common indications for endoscopy were anemia, bleeding and epigastric pain. Metastases presented as solitary (62.5%) or multiple (37.5%) tumors were mainly located in the middle or upper third of stomach. The main primary metastatic tumors were from breast and lung cancer and malignant melanoma. CONCLUSION: As the prognosis of cancer patients has been improving gradually, gastrointestinal (GI) metastases will be encountered more often. Endoscopic examinations should be conducted carefully in patients with malignancies, and endoscopic biopsies and information on the patient’s clinical history are useful for correct diagnosis of gastric metastases.展开更多
Objective: To invetigate the Immunohistochemistry characters and quantitative nmorphometric significance for the mucosa associated lymphoid tissue (MALT) lymphoma of stomach in 14 patients. Methods: The routine paraff...Objective: To invetigate the Immunohistochemistry characters and quantitative nmorphometric significance for the mucosa associated lymphoid tissue (MALT) lymphoma of stomach in 14 patients. Methods: The routine paraffin slides were cut, stained with H.E., and immunochemically by ABC method. The morphologic appearance of nuclei of lymphoma cells were measured with HPIAS-1000 color pathology picture analysis system. Results of the 14 cases, 9 was centrocyte like (CCL) cell lymphoma, 2 CCL with large cell lymphoma, 1 small no cleaved cell lymphoma, 1 large no cleaved cell lymphoma, 1 T immunoblastic malignant lymphoma. The morphologic measurement results showed that there were great significant differences (P<0.001) for the 15 items of morphology parameters between the nuclei of MALT lymphoma cells and those of normal control lymphocytes in stomach. There were great significance differences (P<0.001) or significance (P<0.05) for the most of the 15 items of morphologic parameters of nuclei among the 5 types of MALT lymphoma. Especially, that the values of area, circumference, equivalent diameter, area volume, circumference volume, long diameter, short diameter, practical area were increasing as the malignant degree of classification was rising, which reflect the increasing malignancy of the tumor. Conclusion: It was suggested that with the quantitative morphology measurement method, man could make accurate diagnosis for MALT lymphoma. It offered us a new method to make the diagnosis, so that it had significance. It might be also practicable with morphology measurement method to make the sub classification of MALT lymphoma.展开更多
文摘胃肝样腺癌(hepatoid adenocarcinoma of the stomach,HAS)是一种表现在肝脏外的罕见的特殊胃恶性肿瘤,与一般的胃癌不同,HAS的恶性程度高、侵袭性高,容易出现肝转移、淋巴转移、预后差,但是HAS的诊断、临床病理特征和预后仍有较大的争论.为了帮助临床医生更了解这种胃癌,本文从甲胎蛋白的起源开始对HAS的诊断、临床病理特征及其预后等进行系统综述,从而为这种特殊胃癌的临床诊治提供建设性的意见及帮助.
文摘INTRODUCTIONGastric cancer is one of the most common fatal malignancies in the world. The prognosis is generally poor in advanced gastric cancer .The low survival is related to delayed diagnosis, metastasis and recurrence after operation .The aim of this paper was to find correlation between clinical factors was to find correlation between clinical factors and biologic behavior of gastric cancer in a series of 1200 patients undergoing surgical resection.
文摘BACKGROUND Although pathological response is a common endpoint used to assess the efficacy of neoadjuvant chemotherapy (NAC) for gastric cancer, the problem of a low rate of concordance from evaluations among pathologists remains unresolved. Moreover, there is no globally accepted consensus regarding the optimal evaluation. A previous study based on a clinical trial suggested that pathological response measured using digitally captured virtual microscopic slides predicted patients’ survival well. However, the pathological concordance rate of this approach and its usefulness in clinical practice were unknown. AIM To investigate the prognostic utility of pathological response measured using digital microscopic slides in clinical practice. METHODS We retrospectively evaluated pathological specimens of gastric cancer patients who underwent NAC followed by surgery and achieved R0 resection between March 2009 and May 2015. Residual tumor area and primary tumor beds were measured in one captured image slide, which contained the largest diameter of the resected specimens. We classified patients with < 10% residual tumor relative to the primary tumorous area as responders, and the rest as non-responders;we then compared overall survival (OS) and relapse-free survival (RFS) between these two groups. Next, we compared the prognostic utility of this method using conventional Japanese criteria. RESULTS Fifty-four patients were evaluated. The concordance rate between two evaluators was 96.2%. Median RFS of 25 responders and 29 non-responders was not reached (NR) vs 18.2 mo [hazard ratio (HR)= 0.35, P = 0.023], and median OS was NR vs 40.7 mo (HR = 0.3, P = 0.016), respectively. This prognostic value was statistically significant even after adjustment for age, eastern cooperative oncology group performance status, macroscopic type, reason for NAC, and T- and Nclassification (HR = 0.23, P = 0.018). This result was also observed even in subgroup analyses for different macroscopic types (Borrmann type 4/non-type 4) and histological types (differentiated/undifferentiated). Moreover, the adjusted HR for OS between responders and non-responders was lower in this method than that in the conventional histological evaluation of Japanese Classification of Gastric Carcinoma criteria (0.23 vs 0.39, respectively). CONCLUSION The measurement of pathological response using digitally captured virtual microscopic slides may be useful in clinical practice.
文摘Carcinosarcomas are rare,malignant,biphasic tumors. We report the case of a 62-year-old man with gastric carcinosarcoma,along with its clinical,macroscopic and histopathological features. Macroscopically,a specimen of deformed stomach was obtained that measured 200 mm×150 mm×100 mm. A 150 mm×100 mm× 50 mm exophytic tumoral mass (Borrmann typeⅠ) was found,which involved the posterior wall from the cardia to the antrum. Histopathologically,a mixed type of malignancy was revealed: an adenocarcinoma with intestinal metaplasia,with interposed fascicles of fusiform atypical cells and numerous large,rounded and oval cells. The tumor showed positive histochemistry for cytokeratin 18,epithelial membrane antigen,carcinoembryonic antigen,chromogranin A and vimentin. Liver metastases were diagnosed 8 mo postoperatively,and the patient died 4 mo later. A review of the available literature is also presented.
文摘AIM: To evaluate the clinical and endoscopic patterns in a large series of patients with metastatic tumors in the stomach. METHODS: A total of 64 patients with gastric meta- stases from solid malignant tumors were retros- pectively examined between 1990 and 2005. The clinicopathological findings were reviewed along with tumor characteristics such as endoscopic pattern, location, size and origin of the primary sites. RESULTS: Common indications for endoscopy were anemia, bleeding and epigastric pain. Metastases presented as solitary (62.5%) or multiple (37.5%) tumors were mainly located in the middle or upper third of stomach. The main primary metastatic tumors were from breast and lung cancer and malignant melanoma. CONCLUSION: As the prognosis of cancer patients has been improving gradually, gastrointestinal (GI) metastases will be encountered more often. Endoscopic examinations should be conducted carefully in patients with malignancies, and endoscopic biopsies and information on the patient’s clinical history are useful for correct diagnosis of gastric metastases.
基金The Foundation of National Educational Committee(No.1977-436)a grant from Foundation of Nanjing Municipal Science Committee
文摘Objective: To invetigate the Immunohistochemistry characters and quantitative nmorphometric significance for the mucosa associated lymphoid tissue (MALT) lymphoma of stomach in 14 patients. Methods: The routine paraffin slides were cut, stained with H.E., and immunochemically by ABC method. The morphologic appearance of nuclei of lymphoma cells were measured with HPIAS-1000 color pathology picture analysis system. Results of the 14 cases, 9 was centrocyte like (CCL) cell lymphoma, 2 CCL with large cell lymphoma, 1 small no cleaved cell lymphoma, 1 large no cleaved cell lymphoma, 1 T immunoblastic malignant lymphoma. The morphologic measurement results showed that there were great significant differences (P<0.001) for the 15 items of morphology parameters between the nuclei of MALT lymphoma cells and those of normal control lymphocytes in stomach. There were great significance differences (P<0.001) or significance (P<0.05) for the most of the 15 items of morphologic parameters of nuclei among the 5 types of MALT lymphoma. Especially, that the values of area, circumference, equivalent diameter, area volume, circumference volume, long diameter, short diameter, practical area were increasing as the malignant degree of classification was rising, which reflect the increasing malignancy of the tumor. Conclusion: It was suggested that with the quantitative morphology measurement method, man could make accurate diagnosis for MALT lymphoma. It offered us a new method to make the diagnosis, so that it had significance. It might be also practicable with morphology measurement method to make the sub classification of MALT lymphoma.
