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目的探讨胃淋巴上皮瘤样癌(LELC)的临床病理学特点。方法分析15例胃淋巴上皮瘤样癌的临床病理学特点,免疫组化法检测其免疫表型,比较其与相同分化程度和病理分期的非淋巴上皮瘤样胃腺癌的淋巴结转移率和预后。原位杂交法检测肿瘤组织中EB病毒的感染情况。结果 15例胃淋巴上皮瘤样癌均有显著的淋巴样间质,即大量淋巴细胞、浆细胞弥漫浸润,淋巴滤泡形成,癌细胞呈条索状、不规则的腺管或单个散在分布于大量淋巴细胞背景中。免疫组化:腺上皮细胞CK8/18、AE1/AE3和EMA(+),间质淋巴细胞CD20和CD3(+)。15例均无胃周围淋巴结转移,与同病理分期(T4a N0期)的非淋巴上皮瘤样胃低分化腺癌比较,差异显著(P<0.05)。3例肿瘤细胞EBER(+)。结论胃淋巴上皮瘤样癌是一种罕见类型的低分化腺癌,部分有EB病毒感染,具有特殊的临床病理学特点。
Objective To investigate the clinicopathological features of gastric lymphoepithelioma-like carcinoma (LELC). Methods The clinicopathological characteristics of 15 cases of gastric lymphoepithelioma were analyzed. Immunohistochemistry was used to detect the immunophenotype. The lymph node metastasis rate and prognosis of non - lymphoepithelioma were also compared with those of the same differentiated and pathological stage. In situ hybridization detection of EB virus infection in tumor tissue. Results All the 15 cases of gastric lymphoepithelioma showed significant lymphoid stroma, ie, numerous lymphocytes, diffuse infiltration of plasma cells, formation of lymphoid follicles, cords of cancer cells, irregular glands or single scattered distribution Lots of lymphocytes in the background. Immunohistochemistry: gland epithelial cells CK8 / 18, AE1 / AE3 and EMA (+), interstitial lymphocytes CD20 and CD3 (+). There was no gastric lymph node metastasis in all 15 cases, which was significantly different from non-lymphoepithelioma-like gastric poorly differentiated adenocarcinoma (P <0.05) in the same pathological stage (T4a N0 stage). 3 cases of tumor cells EBER (+). Conclusion Gastric lymphoepithelioma is a rare type of poorly differentiated adenocarcinoma, some of which have Epstein-Barr virus infection and have special clinicopathological features.