胃小细胞癌5例临床病理观察  

Small cell carcinoma of stomach: a clinicopathologic study of 5 cases

作　　者：郭坚[1] 文国英[1] 张根娣[1] 

机构地区：[1]上海建工医院病理科,上海200083

出　　处：《诊断病理学杂志》2005年第4期260-262,i0005,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的观察胃小细胞癌(SCC)的临床病理特点。方法对5例胃SCC的组织切片及免疫组化结果进行观察并结合临床资料及术后随访结果进行分析。结果5例胃SCC患者均为男性,平均年龄57.6岁。主要临床表现为黑便、上腹痛、吞咽困难和消瘦,肿瘤分别位于胃体部、窦部、贲门和残胃吻合口。胃SCC肿瘤主要形成巢片状结构,瘤细胞大小及形态一致,核呈卵圆形、短梭形或不规则形,有异型,染色质为粗细不一的颗粒状,部分深染,核分裂象平均44个/10HPF;4例有片状坏死;2例可见腺样分化并各自伴有类癌或腺癌及印戒细胞癌。各例肿瘤呈明显的浸润性生长并伴有局部淋巴结转移,1例有肝转移。免疫组化示4例SCCSyn、CK8、CKAE1/AE3及NSE(+)。随访4例,3例死于肿瘤,平均生存8.3个月,1例已存活25个月,该例无肿瘤坏死。结论胃SCC是一种组织形态和生物学行为与肺SCC相似的高度恶性肿瘤,对Syn和CK8的表达是其免疫表型特点,肿瘤性坏死是评价预后的重要指标。Objective To observe the clinicopathologic features of gastric small cell carcinoma （SCC）. Methods The histologic sections, immunohistochemical stains results, clinical data and following-up information were analysed. Results Five patients were male with average ages of 57.6 years. The main clinical presentations were melena, epigastralgia, dysghagia and weight loss. The tumors were located in gastric body, antrum, cardia and anastomosing zone of residual stomach, respectively. The gastric SCC was composed of nest and sheet structures and the neoplasm cells were similar in size and appearance. The tumor cell nuclei was oval, short spindle or irregular with atypia, and the nuclear chromatin was irregularly distributed and some with hyperehromation. The mean mitotic figure was 44/10HPF. The tumor necrosis was present in 4 cases, The glandular differentiation with carcinoid or adenocarcinoma and signet-ring cell carcinoma in focal area were found in 2 cases respectively, The neoplasm showed prominent invasive growth pattern. The metastases within local lymph nodes in every case and metastases in one case had been affirmed, The immunohistochemical examinations showed SCC was positive for Syn, CD8, CKAE1/AE3 and NSE in 4 cases, Following up data were obtained in 4 cases and three patients died of SCC with mean surviving time for 8.3 monthes. One patient had survived for 25 months and the tumor necrosis in the histologic sections was not found. Conclusion The gastric SCC is a high grade malignant tumor that histologic features and biologic behavour are similar to pulmonary SCC, The positive reactivity to Syn and CK8 is the important characteristic immunophenotype of this tumor, The tumor necrosis is a significant indicator to evaluate the prognosis.

关 键 词：胃 小细胞癌 临床病理学 

分 类 号：R735.2[医药卫生—肿瘤]