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目的探讨胃淋巴上皮瘤样癌(LELC)的临床病理特点。方法复习307例经手术根治切除的胃癌病理切片,筛选出12例胃LELC(3.9%),总结其临床资料、组织学、免疫表型、EBER原位杂交及随访情况,结合相关文献进行分析讨论。结果 12例胃LELC患者中男性8例,女性4例,平均年龄58岁,发生部位均在近端胃。组织学表现为肿瘤细胞排列成条索状、巢片状结构,部分可见小的腺腔样结构,间质有大量淋巴样细胞浸润。免疫表型示12例肿瘤细胞EMA、CEA和CAM5.2(+),3例CDX-2弱(+),S-100、Syn、CgA和vimentine(-)。原位杂交示9例中癌细胞EBER(+)。随访3个月到5年余,9例无瘤存活,2例死亡(死因不详),1例失访。结论胃LELC是一种罕见的、具有独特临床病理特征的胃癌亚型,大部分病例与EBV感染相关,预后相对较好。
Objective To investigate the clinicopathological features of gastric lymphoepithelioma carcinoma (LELC). Methods A total of 307 gastric LECs (3.9%) were resected by radical gastrectomy. The clinical data, histological features, immunophenotypes, EBER in situ hybridization and follow-up were analyzed. . Results Of the 12 patients with gastric LELC, 8 were male and 4 were female, with a mean age of 58 years. The sites of occurrence were all in the proximal stomach. Histology showed that the tumor cells arranged in a cord-like, lamellar structure, part of the visible glandular cavity-like structure, a large number of interstitial lymphocytic infiltration. The immunophenotypes showed 12 cases of tumor cells EMA, CEA and CAM5.2 (+), 3 cases of CDX-2 weak (+), S-100, Syn, CgA and vimentine (-). In situ hybridization showed EBER (+) in 9 cases. During 3 months to 5 years follow-up, 9 survived without tumor, 2 died (unknown cause of death) and 1 lost follow-up. Conclusion Gastric LELC is a rare, sub-type of gastric cancer with unique clinicopathological features. Most of the cases are associated with EBV infection and the prognosis is relatively good.