胃底腺型腺癌六例临床病理学特征  

Gastric adenocarcinoma of the fundic gland type:clinicopathological analysis of six cases

作　　者：孙玮玮[1] 张黎[1] 顾敏敏[1] 张艳琼 邱承敏 笪倩[2] Sun Weiwei;Zhang Li;Gu Minmin;Zhang Yanqiong;Qiu Chengmin;Da Qian(Department of Pathology,Shanghai Songjiang District Central Hospital,Shanghai 201600,China;Department of Pathology,Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海市松江区中心医院病理科,201600 [2]上海交通大学附属瑞金医院病理科,200025

出　　处：《中华病理学杂志》2020年第4期343-347,共5页Chinese Journal of Pathology

摘　　要：目的:探讨胃底腺型腺癌的临床病理学特征,以提高对该病的认识及诊断水平。方法:收集2014年1月至2019年5月上海市松江区中心医院收治的6例胃底腺型腺癌,分析6例患者的内镜特征、病理形态特征及免疫组织化学检测结果,并结合文献进行探讨。结果:6例胃底腺型腺癌患者中,男性3例,女性3例,平均年龄66岁;临床主要表现为上腹部不适或阵发性隐痛;胃镜检查在胃体部发现隆起或平坦病灶,直径0.4~1.0 cm;病理检查结果显示肿瘤主要由主细胞构成,但也有散在混杂的壁细胞,排列成不规则管状或条索状结构并形成吻合支;免疫组织化学标记结果显示肿瘤细胞表达主细胞标志物MUC6、Pepsingon 1。结论:胃底腺型腺癌是分化好的腺癌的一种罕见类型,是一种新的独立的实体类型,发病率低且目前对其认识不足,容易误诊及漏诊;掌握其内镜特点和组织学形态对提高临床医师的诊断及鉴别诊断能力具有十分重要的意义。Objective To investigate the clinicopathological characteristics of gastric adenocarcinoma of the fundic gland(GA-FG).Methods A total of 6 patients with GA-FG admitted from January 2014 to May 2019 were identified at Shanghai Songjiang District Central Hospital.Analyzed endoscopic findings,pathological characteristics and immunohistochemical staining of the lesions and reviewed relevant literatures.Results Among the 6 patients,3 were male,3 were female,and the mean age was 66 years.The most common clinical presentation was epigastric discomfort.Gastroscopic examination revealed an elevated or flat lesion in the body of the stomach,with a diameter of 0.4 to 1.0 cm.Histopathologically,they mainly composed of main cells,but there were also scattered parietal cells,arranged in an irregular tubular or cord-like structure,and formed anastomosis branches.The tumor cells were immunohistochemically positive for MUC6 and pepsinogen 1.Conclusions GA-FG is a rare variant of well-differentiated adenocarcinoma.It is important to understand its clinical features and histological morphology for more accurate diagnosis.

关 键 词：胃肿瘤 自然腔道内镜手术 诊断 鉴别 

分 类 号：R735[医药卫生—肿瘤]