30例胃肝样腺癌患者临床病理特点及预后分析  

The clinicopathological characteristics and prognosis of 30 patients with hepatoid adenocarcinoma of stomach

作　　者：王闫飞 赖玉梅[2] 寇芙蓉[1] 迟雨佳 郑艳群[1] 朱步东[1] 刘巍[1,3] Yanfei Wang;Yumei Lai;Furong Kou;Yujia Chi;Yanqun Zheng;Budong Zhu;Wei Liu(Daycare Center;Department of Pathology, Palliative Care Center, Peking University Cancer Hospital ＆ Institute, Key laboratory of Car- cinogenesis and Translational Research （Ministry of Education/Beijing）, Beijing 100142, China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所日间化疗病区恶性肿瘤发病机制及转化研究教育部重点实验室,北京市100142 [2]北京大学肿瘤医院暨北京市肿瘤防治研究所日间化疗病区病理科 [3]北京大学肿瘤医院暨北京市肿瘤防治研究所日间化疗病区姑息治疗中心

出　　处：《中国肿瘤临床》2018年第7期355-361,共7页Chinese Journal of Clinical Oncology

基　　金：北京市医院管理局人才培养计划"使命"项目(编号:SML20181102);CSCO-医瘤助手患者教育基金项目(编号:Y-YL2016-008)资助~~

摘　　要：目的:研究胃肝样腺癌患者的临床病理特点及预后因素。方法:回顾性收集2012年8月至2017年6月北京大学肿瘤医院收治的30例胃肝样腺癌患者的临床病理资料并行生存分析。结果:30例胃肝样腺癌患者初诊时29例伴有周围淋巴结转移,7例伴有远处转移,其中6例伴有肝转移。1年生存率为60%,3年生存率为52%。Cox多因素回归模型分析显示肿瘤标记物CA199升高、淋巴结分期、是否行根治性手术及血清甲胎蛋白(α-fetoprotein,AFP)免疫组织化学染色强度是影响预后的独立危险因素(P<0.05)。结论:本研究发现淋巴结分期、肿瘤标记物CA199升高及AFP染色强度是预后不良的独立危险因素,多学科查房制定综合治疗策略争取根治可改善预后。Objective： To review the clinicopathological characteristics and analyze the prognostic factors of hepatoid adenocarcinoma of stomach（HAS）. Methods： From August 2012 to June 2017, 30 patients with HAS were diagnosed in Daycare of Peking University Cancer Hospital. Clinicopathological data and follow-up information of these patients were retrospectively collected and analyzed. Results： The median age of these 30 patients was 58 years at diagnosis, with a male-to-female ratio of 2.75：1. Twenty-nine patients were confirmed to have lymph node metastases and 7 patients had distant metastases. Ten patients died because of the cancer within the follow-up period. The 1-and 3-year survival rates were 60% and 52%, respectively. Cox multivariate regression revealed that elevated serum CA199 levels, higher lymph node staging, not having undergone radical surgery, and stronger immunohistochemical（IHC） staining intensity of alpha fetoprotein（AFP） were independent poor prognostic factors. Conclusions： Elevated serum CA199 levels, lymph node staging, and IHC staining intensity of AFP are verified in this study as independent risk factors of poor outcome in HAS patients.Early detection and diagnosis of the disease may improve the clinical prognosis. Multidisciplinary team discussions are important in making therapy decisions and radical surgery should be performed whenever possible.

关 键 词：胃肝样腺癌 甲胎蛋白 预后 

分 类 号：R735.2[医药卫生—肿瘤]