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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。
Objective To investigate the pathological features and clinical features of gastric adenoid carcinoma. Methods The clinical data of 9 patients with gastric adenocarcinoma of the liver and stomach admitted from Chongyang People’s Hospital from January 2005 to January 2012 were retrospectively analyzed. Results The clinical manifestations of the 9 patients were mainly abdominal pain, abdominal distension, melena and other gastrointestinal symptoms. The serum AFP level was continuously increased (92.34-1984.03 ng / ml), the positive rate was 77.78% (7 / 9); 33.33% (3/9) were detected by B-mode ultrasonography or CT with liver metastasis: 66.67% (6/9) had gastric antrum, and most of the pathological types were ulcer (77.78% 7/9). The appearance of hepatocellular carcinoma-like differentiation in gastric cancer tissue is its unique pathological morphology, and 9 patients survived an average of 19 months. Conclusions Gastric adenoid adenocarcinoma has unique pathological features and clinical features. Serum AFP is positive, with high age of onset, easy metastasis, poor prognosis and prognosis than other gastric adenocarcinomas, which should be paid more attention by clinicians.