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报道4例罕见的AFP阳性结肠和直肠癌,此癌多见于中、老年男性患者,具有独特的病理形态与临床生物学行为,血清AFP明显增高。病理组织形态特点是:除1例为单纯性腺癌外,另3例均见两种不同而又密切相关的腺癌区和肝样分化区。免疫组织化学染色,显示在肝样区的癌细胞浆内含有AFP、AAT和ACT成份,而在腺癌区的癌细胞浆内则以CEA成份为主。此癌高度恶性,由于AFP的免疫抑制作用,常发生肝转移(3/4),所以预后不良。本组4例均死亡,术后平均生存16.25个月。综合文献与本组结果,作者认为此癌应列为结肠与直肠癌的一个特殊亚型。
Four cases of rare AFP-positive colon and rectal cancer were reported. This cancer is more common in middle-aged and elderly male patients. It has a unique pathological morphology and clinical biological behavior, and serum AFP is significantly increased. The histopathologic features were: In addition to 1 case of simple adenocarcinoma, the other 3 cases all had two distinct but closely related adenocarcinoma areas and hepatic-like differentiation areas. Immunohistochemical staining showed that AFP, AAT, and ACT components were contained in the hepatocyte-like cancer cell paste, while the CEA components were dominant in the cancer cell paste of the adenocarcinoma area. This cancer is highly malignant. Due to the immunosuppressive effects of AFP, hepatic metastasis (3/4) often occurs and the prognosis is poor. Four patients died in this group, and the average survival time was 16.25 months. Comprehensive literature and the results of this group, the authors believe that this cancer should be classified as a special subtype of colon and rectal cancer.