主细胞为主型胃泌酸腺肿瘤9例报道并文献复习  

Gastric oxyntic gland tumour(chief cell predominant type):report of 9 cases and literature review

作　　者：王涛 罗华 Wang Tao;Luo Hua(Department of Pathology,Ya’an People’s Hospital)

机构地区：[1]雅安市人民医院病理科,雅安625000

出　　处：《重庆医科大学学报》2022年第2期209-212,共4页Journal of Chongqing Medical University

摘　　要：目的:探讨主细胞为主型胃泌酸腺肿瘤的临床病理特征。方法:收集雅安市人民医院2017年12月至2020年7月诊治的9例主细胞为主型胃泌酸腺肿瘤的临床病理资料,分析内镜特征、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:9例患者中5例为女性,4例为男性,中位年龄54岁。其中胃底腺型胃癌(gastric adenocarcinoma of fundic gland type,GA-FG)6例、泌酸腺腺瘤(gastric oxyntic gland adenoma,GOGA)3例。最常见的症状是腹部隐痛(5/9)。胃镜提示胃体或胃底的浅表隆起型(8/9)或浅表平坦型病变(1/9),病灶最大直径2~6 mm。GA-FG及GOGA均以主细胞成分为主,伴有壁细胞和颈黏液细胞,细胞异型性小,排列成不规则的腺管状。GA-FG中查见肿瘤周围间隙(5/6)及肿瘤周围纤维化(1/6)。免疫表型显示主细胞表达胃蛋白酶原Ⅰ、壁细胞表达H+-K^(+)-ATP酶、颈黏液细胞表达黏蛋白6。4例患者获得12~25个月随访,均未见复发。结论:胃的主细胞为主型泌酸腺肿瘤是罕见且具有独特病理学特征的肿瘤,预后较好。Objective:To assess the clinicopathological features of gastric oxyntic gland tumour chief cell predominant type(GOGTCCPT).Methods:Clinicopathologic characteristics of 9 patients with GOGT-CCPT admitted to Ya’an People’s Hospital from December 2017 to July 2020 were collected in the study.The endoscopic features,pathological features and immunohistochemical results were analyzed,and the relevant literatures were discussed.Results:Among the 9 patients,5 were female and 4 were male,with a median age of 54 years,including 6 cases of gastric adenocarcinoma of fundic gland type(GA-FG)and 3 cases of gastric oxyntic gland adenoma(GOGA).The most common symptom was abdominal pain(5/9).Gastroscopy revealed an elevated(8/9)or flat(1/9)lesion in the gastric corpus and the gastric fundus,with a diameter of 2 to 6 mm.Clinicopathological examination showed that the tumor was mostly located in the lamina propria,and both GA-FG and GOGA were mainly composed of chief cells,but there were also scattered parietal cells and mucous neck cells,with mild atypia and arranged in irregular glandular patterns.Peritumor space(5/6)and fibrosis(1/6)could be found among GA-FG cases.Immunophenotype showed that pepsinogenⅠwas expressed in chief cells,H+-K^(+)-ATPase in parietal cells and mucin 6 in cervical mucus cells.Four patients had a follow-up for 12-25 months,without any recurrence.Conclusion:GOGT-CCPT is a rare tumor with a distinct clinicopathologic features and a favorable prognosis.

关 键 词：胃泌酸腺肿瘤 泌酸腺腺瘤 胃底腺型胃癌 

分 类 号：R735.2[医药卫生—肿瘤]