首页|产甲胎蛋白结直肠癌42例临床病理特征及预后分析

产甲胎蛋白结直肠癌42例临床病理特征及预后分析

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目的 探讨产甲胎蛋白(Alpha-fetoprotein,AFP)结直肠癌的临床病理特征及预后.方法 收集术前检测了血清AFP的结直肠癌手术标本2 012例,筛选42例产AFP结直肠癌和同期性别、年龄、分期完全匹配的传统结直肠癌的临床病理资料.采用免疫组化EnVision法检测HER2、错配修复蛋白、p53、AFP、Glypican3、SALL4的表达,HER2 2+病例行FISH检测.可疑的壁外血管侵犯病例行弹力纤维染色.比较两组病例的临床病理特征和预后差异,将产AFP结直肠癌分为AFP高值组和AFP低值组,并比较两组临床病理特征和预后差异.结果 产AFP结直肠癌占同期结直肠癌的2.1%(42/2 012),产AFP结直肠癌和对照组的壁外血管侵犯率分别为35.7%、14.3%,中+高级别肿瘤出芽率分别为61.9%、40.5%,5年生存率分别为66.8%、85.1%,两组间差异有显著性(P<0.05).AFP高值组肿瘤61.9%位于直肠,低值组23.8%位于直肠,两组间差异有显著性(P<0.05).结论 产AFP结直肠癌是一种少见类型的肠癌,肿瘤易出现壁外血管侵犯和中高级别肿瘤出芽,预后差.
Clinicopathologic characteristics and prognosis of Alpha-fetoprotein-producing colorectal carcinoma:analyses of 42 cases
Purpose To investigate the clinicopathological features and prognosis of alpha-fetoprotein-producing colorectal carcinoma(AFPCRC).Methods 42 cases of AFPCRC from 2 012 colorectal carcinomas of preoperative serum AFP detected and surgically resected were identified.The clinicopathological data of AFPCRC and other 42 cases of conventional colorectal carcinoma exactly matched for age,gender,stage were also col-lected.Immunohistochemical EnVision method was performed to detect the expression of HER2,MMR,p53,AFP,Glypican3,and SALL4.Cases presenting HER2 2+were further analyzed by fluorescence in situ hybridization.Elastic staining was per-formed in cases with ambiguous extramural venous invasion.The clinicopathlogical features and prognosis between two groups were compared.Cases with AFPCRC were divided into high-AFP group and low-AFP group.The clinicopathological features and prognosis of the two groups were compared.Results AF-PCRC accounted for 2.1%(42/2 012)of colorectal carcinoma in the same period.The frequency of extramural vascular inva-sion and moderate/high grade of tumor budding of AFPCRC was 35.7%and 61.9%,while that of control group was 14.3%and 40.5%respectively.The 5-year survival rate of AFPCRC and control group was 66.8%and 85.1%respectively.The differ-ence of aforementioned clinicopathological features between 2 groups was significant(P<0.05).The proportion of tumor in rectum in the high-AFP group was significantly higher than that in the low-AFP group(61.9%vs 23.8%,P<0.05).Conclu-sion AFPCRC is a rare subset of colorectal carcinoma,which has a propensity for extramural vessel invasion,moderate-or high-grade of tumor budding and poor prognosis.

colorectal neoplasmsAlpha-fetoproteinprogno-sisimmunohistochemistryfluorescence in situ hybridization

张馨文、周晓莉、顾文贤、王更芳、程羽青

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大连医科大学研究生院,大连 116044

南京医科大学附属常州第二人民医院病理科,常州 213003

结直肠肿瘤 甲胎蛋白 预后 免疫组织化学 FISH

常州市科技局海外人才专项常州市"十四五"卫生健康高层次人才培养工程

CQ202040362022CZBJ079

2024

临床与实验病理学杂志
安徽医科大学,中华医学会安徽分会

临床与实验病理学杂志

CSTPCD北大核心
影响因子:0.776
ISSN:1001-7399
年,卷(期):2024.40(6)