首页|胃底腺型肿瘤的内镜与病理学分析

胃底腺型肿瘤的内镜与病理学分析

扫码查看
目的:探讨胃底腺型肿瘤胃泌酸腺腺瘤(oxyutic gland adenoma,OGA)和胃底腺腺癌(gastric adenocarcinoma of fundic gland type,GA-FG)的临床病理特征.方法:回顾性分析 2020年 8月至 2023年 2月福建省肿瘤医院收治的 6例胃底腺型肿瘤患者,分析其临床资料、内镜学特征、病理特征、免疫组织化学结果,治疗及预后情况.结果:6例患者中男性 1例,女性 5例,平均年龄 57岁.主要发生部位为胃底、胃体,以浅表隆起型多见.病理形态特点为胃底腺型肿瘤大多位于胃黏膜深层,表现为腺体结构紊乱,主要由主细胞型细胞构成.其中OGA 3例,GA-FG 3例.免疫组织化学表达结果为胃蛋白酶原重组人抗体 1(pepsinogen 1)阳性 5例,MUC6 5例,突触素(synaptophysin,Syn)阳性 6例,嗜铬蛋白(chromogranin,CgA)均为阴性,肿瘤增殖标记物(Ki-67)<10%.结论:OGA与GA-FG发病率低,无明显的内镜学特异性,如内镜医师认识不足,易误诊漏诊;免疫组织化学有助于鉴别诊断,首选内镜下黏膜切除或者剥离术治疗.
Endoscopic and pathological analyses of fundic gland-type tumors
Objective:To investigate the clinicopathological characteristics of oxyntic gland adenoma(OGA)and gastric adenocarcinoma of the fundic gland type(GA-FG).Methods:Six cases of fundic gland-type tumors(three OGA and three GA-FG)diagnosed at the Fujian Cancer Hospital between August 2020 and February 2023 were retrospectively analyzed.The clinical data,endoscopic features,pathological charac-teristics,immunohistochemical results,treatment,and prognosis were analyzed.Results:Six patients with an average age of 57 years,in-cluding one male and five females,were mainly affected in the gastric fundus and body,with the superficial elevated type being the most common.The pathological features of gastric gland-type tumors are mostly located in the deep layer of the gastric mucosa,showing a dis-ordered glandular structure mainly composed of chief cell-type cells.There were three cases of OGA and three cases of GA-FG.Immunohis-tochemical results showed that pepsinogen 1 was positive in five cases,mucin 6(MUC6)in five cases,synaptophysin(Syn)in six cases,chro-mogranin(CgA)was negative in all cases,and Ki-67 was less than 10%.Conclusions:The incidences of OGA and GA-FG are low,and there is no obvious endoscopic specificity.Endoscopy physicians have an insufficient understanding,which can easily lead to misdiagnoses and missed diagnoses.Immunohistochemistry is helpful for the differential diagnosis,and endoscopic mucosal resection or stripping is the pre-ferred treatment option.

oxyutic gland adenoma(OGA)gastric adenocarcinoma of fundic gland type(GA-FG)MUC6endoscopic submucosal dis-section(ESD)

陈建华、施宏、陈素玉、黄瑞、林丽琳、张宇

展开 >

福建医科大学肿瘤临床医学院,福建省肿瘤医院消化内镜中心(福州市 350014)

胃泌酸腺腺瘤 胃底腺腺癌 MUC6 内镜下黏膜下剥离术

福建省科技计划引导性项目

2020Y0068

2024

中国肿瘤临床
中国抗癌协会

中国肿瘤临床

CSTPCD北大核心
影响因子:1.32
ISSN:1000-8179
年,卷(期):2024.51(15)
  • 1