胃原发性淋巴上皮瘤样癌6例临床病理学观察  

Lymphoepithelioma-like gastric carcinoma: a clinicopathologic study of six cases

作　　者：莫超华 温宗华[2] 莫祥兰[2] 刘冰薇 梁劲劲 

机构地区：[1]广西壮族自治区梧州市人民医院病理科,梧州543000 [2]广西壮族自治区人民医院病理科,南宁530021

出　　处：《临床与实验病理学杂志》2015年第2期154-156,160,共4页Chinese Journal of Clinical and Experimental Pathology

基　　金：国家自然科学基金(81360355);广西卫生厅科研课题(Z2013355)

摘　　要：目的：探讨胃淋巴上皮瘤样癌（ lymphoepithelioma-like gastric carcinoma, LLGC）临床病理学特征、免疫表型及与EB病毒（ EBV）感染的关系。方法收集6例LLGC,对其临床特征、病理学形态和免疫表型进行观察,采用原位杂交法检测EBV编码小RNA（ EBER）的表达。结果6例均为男性,发病年龄47~68岁,平均55岁,6例均累及胃体。镜检：在丰富的淋巴细胞背景中见散在的未分化癌细胞条索或细胞巢,偶尔在近黏膜表面出现发育差的腺管结构,间质内纤维组织少,见淋巴滤泡形成。瘤细胞表达CKpan、CK19、CEA及EBER,不表达CK7、CK20、CK5/6及LMP1；间质淋巴细胞表达CD3或CD20,不表达EBER。6例患者随访6~57个月,均无瘤存活。结论 LLGC是一种罕见的具有独特临床病理学特征的胃癌亚型,预后较好,与EBV感染密切相关。Purpose To investigate the clinicopathologic features and immunophenotype as well as its association with EBV infection of lymphoepithelioma-like gastric carcinoma （LLGC）. Methods The clinical pathological data were reviewed, morphological changes were observed and immunohistochemical staining was done in 6 cases of LLGC. The expression of EBV-encoded small RNA （ EBER） in the 6 cases of LLGC were carried out by in situ hybridization. Results All of the six patients were male, the age was arranged 47 to 68 years, with mean of 55 years. All of the six cases, the lesions were located in gastric body. Microscopically, the undifferentiated carcinoma cells were arranged in cords and nests, scattering in the lymphoid-rich stroma, occasionally poor development tubular struc-tures were seen in the near surface of mucosa. Lymphoid follicles could be seen with lack of fibrous tissues reaction in the tumor stro-ma. Immunohistochemical staining and in situ hybridization showed the tumor cells were diffusely positive for CKpan, CK19, CEA and EBER, but negative to CK7, CK20, CK5/6 and LMP1; interstitial lymphocytes expressed CD3 or CD20, while lost expression of EBER. Follow-up for 6-57 months, all of the 6 patients were survived without tumor. Conclusions The LLGC is a rare and unique subtype of gastric carcinoma with good prognosis, which is often associated with EBV infection.

关 键 词：胃肿瘤 淋巴上皮瘤样癌 临床病理 EB病毒 

分 类 号：R735.2[医药卫生—肿瘤]