伴肠母细胞分化胃腺癌的临床病理分析  

Clinicopathological features of the gastric adenocarcinoma withenteroblastic differentiation

作　　者：樊蕊蕊 王桂梅 FAN Rui-rui;WANG Gui-mei(Department of Pathology,Xiang’an Hospital of Xiamen University,School of Medicine,Xiamen 361002,China)

机构地区：[1]厦门大学附属翔安医院病理科,福建厦门361002

出　　处：《诊断病理学杂志》2024年第11期1064-1067,共4页Chinese Journal of Diagnostic Pathology

基　　金：厦门市自然科学基金项目(3502Z20227118);厦门市医疗卫生指导性项目(3502720244ZD1156);福建省自然科学基金计划资助项目(2023J01013)。

摘　　要：目的分析伴肠母细胞分化胃腺癌(GAED)的临床病理特征、免疫表型、诊断与鉴别诊断依据。方法收集厦门大学附属翔安医院GAED患者的临床病理资料,通过H&E染色、免疫组织化学染色、荧光原位杂交(FISH)等方法分析GAED的临床病理特征。结果2例均为男性,1例为浅表隆起型,1例为溃疡型。镜下:肿瘤细胞排列成腺管状、筛状结构,细胞呈立方或柱状,胞界相对清晰,具有特征性的丰富透明胞质,2例均伴有脉管内癌栓。免疫组化结果:肿瘤细胞表达CDX2(2/2)、CD10(2/2)、SALL4(2/2)、Heppar-1(2/2)、Glypican-3(2/2)、AFP(2/2)、HER2(1/2,3+)。FISH检测显示HER2基因扩增(1/2)。结论GAED临床较为罕见,具有相对特征性的组织形态学及免疫表型,预后较普通型腺癌差。Objective To investigate the clinicopathological features of the gastric adenocarcinoma with enteroblastic differentiation(GAED).Methods Clinicopathological data of GAED were collected and analyzed by H&E staining,immunohistochemistry,and FISH.Results Both patients were male.One patient had superficial protuberant type and the other had ulcerative type.Microscopically,the tumor cells were arranged in glandular,cribriform structures,cuboidal or columnar,with relatively clear cell borders and abundant clear cytoplasm.Vascular invasion was present in both cases.Immunohistochemical staining results showed tumor cells were positive for CDX2(2/2),CD10(2/2),SALL4(2/2),Heppar-1(2/2),Glypican-3(2/2),AFP(2/2),HER2(1/2,3+).FISH showed HER2 gene amplification(1/2).Conclusion Gastric adenocarcinoma with enteroblastic differentiation is a rare disease with relatively characteristic histomorphology and immunophenotype.The prognosis is worse than that of common adenocarcinoma.

关 键 词：胃 腺癌 肠母细胞分化 组织病理 诊断及鉴别诊断 

分 类 号：R735.2[医药卫生—肿瘤]