胃钙化性纤维性肿瘤四例报告并文献复习  

Case report of gastric calcifying fibrous tumor and literature review

作　　者：刘霞[1] 古丽米拉.巴依坦 师艺[1] 李俊芝[1] 张巍[1] 哈德提.别克米托夫 

机构地区：[1]新疆医科大学第一附属医院病理科,新疆乌鲁木齐830054 [2]新疆人口和计划生育科研所病理科,新疆乌鲁木齐830011

出　　处：《中华肿瘤防治杂志》2015年第10期800-805,共6页Chinese Journal of Cancer Prevention and Treatment

基　　金：新疆维吾尔自治区科技支撑计划(201233142)

摘　　要：目的探讨胃壁钙化性纤维性肿瘤（calcifying fibrous tumor,CFT）临床病理特征及可能的发病原因。方法回顾性分析2012-04-18-2014-04-04新疆医科大学第一附属医院4例CFT患者的临床资料及组织形态学特征,应用免疫组化方法检测免疫表型,原位杂交检测EBER及HPV16/18,FISH技术及RT-PCR检测间变性淋巴瘤激酶（anaplasticlymphoma kinase,ALK）,并复习相关文献。结果 4例患者中,男1例,女3例,年龄37~74岁,平均57.3岁。病变均发生于胃体,以黏膜下肿块表现,单发,最大径0.5~3.0cm。形态学与其他部位的钙化性纤维性肿瘤相似。免疫组织化学梭形纤维母细胞VIM阳性,CD117、Dog1、ALK1、F8a、HHV8、ER、SMA、DES、S100及AE1/AE3均阴性。浸润的淋巴细胞为多克隆性,以T细胞为主,且以CD8表达占优,浆细胞：IgG＋,IgG4＋。原位杂交EBER及HPV16/18检测阴性,FISH技术检测ALK基因无融合,RT-PCR结果显示ALK无突变。结论胃CFT以单发表现,中老年常见,多位于胃体,瘤体较小,临床呈良性。病原学EB、HIV及HPV检测阴性,与炎性肌纤维母细胞瘤无明确直接联系,疾病发生发展中以细胞免疫应答占优。OBJECTIVE To study the clinicopathology and pathologenesis of gastric calcifying fibrous tumor （CFT）. METHODS Four cases of gastric CFT from First Affiliated Hospital,Xinjiang Medical University between April 18 th,2012 and April 4th,2014 were analyzed and related literatures were studied. RESULTS There were 1 male and 3 females,with age ranged from 37 to 74 years （mean 57.3 years）. All tumors were located in body and revealed a polypoid submucosal mass,and the size ranged from 0.5 to 3 cm. Histologically, tumors showed hypocellular sclerosis with coarse collagen and scattered or patchy mononuclear inflammatory infiltrates composed plasma cells and lymphocytes. Psammom- atous and dystrophic calcifications were found. Immunohistochemically,all tumors were positive for VIM,and negative for CD117, Dog 1, ALK1, F8 a, H H V8, ER, SMA, DES, $100 and AE1/AE3. Plasma cells were positive for IgG and IgG4. In situ hybridization EBER and HPV16/18 tests were negative. ALK gene fusion and mutation were not detected. CONCLU- SIONS Gastric CFT has a predilection for the stomach body,and smaller tumor size,older age at presentation,and uni- formly benign course without recurrence. There is no histogenetic relationship between CFT and inflammatory myofibro- blastic tumor. This disease develops dominantly in cell-mediated immune response.

关 键 词：胃肿瘤 钙化性纤维性肿瘤 分子学检测 病因学 

分 类 号：R735.2[医药卫生—肿瘤]