胃肝样腺癌伴肠母细胞分化1例  

Hepatoid adenocarcinoma of the stomach with enteroblast differentiation:A case report

作　　者：冯籽言 汪安江 刘广宇 胡珊 许翠 许雯 Zi-Yan Feng;An-Jiang Wang;Guang-Yu Liu;Shan Hu;Cui Xu;Wen Xu(Department of Gastroenterology,Shenzhen Hospital,Southern Medical University,Shenzhen 518000,Guangdong Province,China;Department of Gastrointestinal Surgery,Shenzhen Hospital,Southern Medical University,Shenzhen 518000,Guangdong Province,China;Department of Nuclear Medicine,Shenzhen Hospital,Southern Medical University,Shenzhen 518000,Guangdong Province,China;Department of Imaging,Shenzhen Hospital,Southern Medical University,Shenzhen 518000,Guangdong Province,China;Shenzhen Clinical Research Center for Digestive Disease,Shenzhen 518000,Guangdong Province,China)

机构地区：[1]南方医科大学深圳医院消化内科,广东省深圳市518000 [2]南方医科大学深圳医院胃肠外科,广东省深圳市518000 [3]南方医科大学深圳医院核医学科,广东省深圳市518000 [4]南方医科大学深圳医院影像科,广东省深圳市518000 [5]深圳市消化系统疾病临床研究中心,广东省深圳市518000

出　　处：《世界华人消化杂志》2025年第3期245-250,共6页World Chinese Journal of Digestology

摘　　要：背景胃肝样腺癌是胃癌罕见分类,无特异性表现,特征为肿瘤组织兼具胃腺癌与肝细胞癌样分化,临床罕见,易造成误诊.病例简介64岁女性患者,体检发现甲胎蛋白升高入院.检查示血红蛋白略低,甲胎蛋白、癌胚抗原升高,其他指标正常.影像检查发现肝胃间隙及肝门区多发淋巴结,胃镜见胃角溃疡.活检诊断为低分化腺癌.正电子发射断层-X线计算机断层组合系统提示胃原发恶性病变及转移性淋巴结.结论胃肝样腺癌罕见且高度侵袭性,易误诊,本例同时伴肠母细胞分化,更为罕见.经胃大部切除+化疗有效,患者预后良好,甲胎蛋白、癌胚抗原下降,未见复发转移.BACKGROUND Hepatoid adenocarcinoma of the stomach(HAS)is a rare subtype of stomach carcinoma without specific clinical or endoscopic manifestations.The pathology is characterized by the presence of both gastric adenocarcinoma and hepatocellular carcinoma differentiation regions in the tumor tissue with some characteristic immunohistochemical markers.Here,we report a rare case of HAS with enteroblast differentiation in an elderly woman.CASE SUMMARY A patient was found to have elevated alpha-fetoprotein during a physical examination.The patient was pathologically confirmed to have HAS with enteroblast differentiation after subtotal gastrectomy.CONCLUSION HAS represents an uncommon subclassification of gastric cancer devoid of distinctive clinical manifestations.It is distinguished by the coexistence of gastric adenocarcinoma and hepatocellular carcinomatoid differentiation within the tumor tissue,presenting a unique histopathological profile.Given its scarcity in clinical practice,pathological diagnosis remains the definitive gold standard for identifying this entity.

关 键 词：胃肝样腺癌 甲胎蛋白 产甲胎蛋白胃癌 原发性肝癌 

分 类 号：R73[医药卫生—肿瘤]