胃肝样腺癌9例并文献复习

目的探讨胃肝样腺癌的病理形态和临床特点。方法回顾性分析2005年1月至2012年1月崇阳县人民医院收治的9例胃肝样腺癌患者的临床资料。结果 9例患者临床表现以上腹部疼痛、腹胀、黑便等消化道症状为主;血清甲胎蛋白(AFP)含量异常持续增高(92.34～1 984.03 ng/ml),阳性率为77.78%(7/9);B超或CT检出伴有肝转移者为33.33%(3/9):该病以胃窦部多发,占66.67%(6/9),病理类型多为溃疡型(77.78%,7/9);胃癌组织内出现肝细胞癌样分化区是其特有的病理形态,9例患者平均存活19个月。结论胃肝样腺癌具有独特的病理形态和临床特点,血清AFP阳性,发病年龄高,易转移,治疗及预后较其他胃腺癌差,应引起临床医师足够重视。

Gastric Hepatoid Adenocarcinoma :9 Cases Report and Review of the Literature

Objective To investigate histological characteristics and clinical featuers of gastric hepatoid adenocarcinoma.Methods 9 patients with gastric hepatoid adenocarcinoma(GHAC) were evaluated for histology and clinical data from January 2005 to January 2012 in renmin hospital of Chongyang.Results In the 9 cases,the main clinical manifestations were upper abdominal pain,distension,melena and other gastrointestinal symptems;Serum alpha-fetoprotein(AFP) levels were high level(92.34~1984.03 ng/ml) with a positive rate of 77.78%.The percentage of liver metastasis detected by US-B or CT was 33.33%(3/9),and mostly seen at the gastric sinus(66.67%,6/9).The pathologic type was mostly anabrosis(77.78%,7/9).Hepatocellular carcinoma-like differentiation zone is a unique pathological in GHAC.The average time of survival of 9 patients was 19 months.Conclusion GHAC has its own histological characteristics and clinical features,such as positive AFP levels,higher incidence of in the elderly,aggressive,poor prognosis,which should be received much concern by clinicians.