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目的 研究胃的肝样腺癌 (hepatoidadenocarcinomaofthestomach ,HAS)的病理形态和临床特点。方法 采用常规HE染色和免疫组织化学方法对 3例胃的肝样腺癌进行研究。结果 3例HAS细胞胞质内均有甲胎蛋白 (AFP) ,α 抗胰糜蛋白酶(ACT )和α 抗胰蛋白酶 (AAT )表达。肿瘤的发病部位以胃窦部多见 ,3例均有局部胃壁脉管浸润和局部淋巴结转移 ,其中 2例有肝转移 ,分别死于术后 3个月和 1年。另外 1例术后 2个月复查未见肝转移 ,以后失访。结论 胃的肝样腺癌是原发于胃粘膜腺体的肿瘤 ,形态上具有肝细胞样分化和腺样分化 2种结构 ,因常伴有肝转移故预后较普通型胃癌差。
Objective To study the pathological and clinical characteristics of hepatoid adenocarcinoma of the stomach (HAS). Methods Three cases of gastric hepatoid adenocarcinoma were studied by routine HE staining and immunohistochemistry. Results The expression of alpha-fetoprotein (AFP), alpha antitrypsin (ACT) and alpha antitrypsin (AAT) was found in the cytoplasm of three HAS cells. The site of tumor was more common in the gastric antrum. 3 cases had local vasculature infiltration and regional lymph node metastases, of which 2 cases had hepatic metastases and died at 3 months and 1 year after surgery. In another case, there was no liver metastasis after 2 months of follow-up and it was later lost to follow-up. Conclusion Gastric hepatoid adenocarcinoma is a primary tumor in the gastric mucosa. It has two structures, hepatocyte-like differentiation and adenoid differentiation. Because hepatic metastasis is often accompanied, the prognosis is worse than that of common gastric cancer.