Clinicopathological Characteristics and Prognosis of 12 Cases of Hepatoid Adenocarcinoma of the Stomach
Objective To summarize clinical data and explore the clinicopathological features and prognoses of 12 patients with hepatoid adenocarcinoma of the stomach(HAS).Methods A retrospective analysis was performed on the clinicopathological data of 12 patients with HAS admitted to the General Hospital of Ningxia Medical University from January 2016 to December 2022.The pathological and immunohistochemical results were determined by the review of tumor tissue sections by two pathologists.Patient demographics and tumor characteristics were summarized by descriptive statistical methods.COX univariate and multivariate regression analysis were used to analyze the prognosis of patients.Results Among the 12 patients,9 patients were males and 3 patients were females,with a male-to-female ratio of 3∶1.The median age at diagnosis of disease was 60 years.The most common pathogenesis was located in the antrum(41.7%),and the lesion type was mainly Borrmann type Ⅲ(ulcer type)(45.5%),diffuse type according to Lauren classification(58.3%),and the degree of tumor differentiation was mostly poorly differentiated(83.3%).Eight patients had measured serum carcinoembryonic antigen(CEA)≥5 ng·mL-1.Serum alpha-fetal protein(AFP)was measured in 6 pa-tients,and AFP levels were elevated in 4(66.7%),including one≥300 ng·mL-1(16.7%).Eleven patients underwent surgery,and 5 cases of preoperative distant metastasis,of which 4 patients had liver and retroperitoneal lymph node metastasis at the same time.Only retroperitoneal lymph node metastases occurred in 1 patient.Vascular invasion occurred in 10 patients(83.3%)and nerve invasion occurred in 7 patients(58.3%).According to the proportion of hepatic differentiation area,4 cases(33.3%)were simple HAS and 8(66.7%)were mixed HAS.Based on the TNM staging of AJCC 8th edition,there were 1 case of stageⅠ,1 case of stageⅡ,5 cases of stageⅢand 5 cases of stageⅣ.The median survival time was 16 months,and the 1,3 and 5-years survival rates were 83.0%,41.0%and 20.0%,respectively.The univariate Cox analysis found that whether CEA,clinical stage,the proportion of hepatic area,whether radical surgery was performed,whether distant metastases were present,whether distant metastases were liver metastases,and whether HepPar-1 ex-pression may be related to prognosis.Conclusion HAS is a rare heterogeneous tumor,often accompanied by elevated serum AFP and expression of some hepatocellular carcinoma markers,prone to vascular invasion,lymph nodes,and distant metastasis,and the prognosis is very poor.
hepatoid adenocarcinoma of the stomachclinicopathological featuresimmunohistochemistryprog-nosis
万方数据
维普
