胃肝样腺癌11例分析_李小毅

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1、《癌症进展》2012年3月第10卷第2期182*论著＊ONCOLOGYPROGRESS，Mar2012，Vol.10，No.2胃肝样腺癌11例分析1#211李小毅钟定荣刘洪沨高维生12中国医学科学院北京协和医学院北京协和医院基本外科，病理科，北京100730摘要:目的探讨胃肝样腺癌(HAS)的临床和病理特点及其诊断和治疗。方法回顾我院11例胃肝样腺癌的临床病理特点及其诊断和治疗。结果11例肝样腺癌平均59.27岁，其中男性9例;治疗前血清AFP均升高(5/5);病变均为溃疡或溃疡型肿物、低分化或中低分化腺癌伴部分肝样腺癌，位于胃窦部2例，胃体部3例，贲门部6

2、例;同时有肝转移者5例(5/11);手术切除者7例，其中3例行根治性手术;7例患者均有淋巴结转移;临床病理分期Ⅲ期2例、Ⅳ期9例;5例手术患者、3例未手术患者行不同疗程的全身化疗±介入化疗;患者总体预后差，死亡4例，其生存期为1～10个月。结论胃肝样腺癌是一类特殊的胃癌，容易发生淋巴结、肝脏转移，临床疗效差，应予以重视。关键词:胃肿瘤肝样腺癌甲胎蛋白类诊断治疗中图分类号:R735.2文献标识码:AHepatoidadenocarcinomaofstomach:Areportof11cases1#211LiXiaoyiZhongDingrongLiuHongf

3、engGaoWeisheng12DepartmentofGeneralSurgery，DepartmentofPathology，PekingUnionMedicalCollegeHospital，ChineseAcademyofMedicalSciences＆PekingUnionMedicalCollege，Beijing100730，ChinaAbstract:ObjectiveToinvestigatetheclinicalcharacteristics，diagnosisandtreatmentofhepatoidadenocarcino-maof

4、stomach．MethodsClinicaldataof11hepatoidadenocarcinomaofstomachwereanalyzedretrospectively．ResultsThemeanageofthe11caseswas59.27years，inwhichninecasesweremale．SerumAFPlevelelevatedinall5casestestedbeforetreatment．Alltumorspresentedulcerlesions，diagnosedaspoorlyormoderately-poorlydif

5、ferentiatedadeno-carcinoma．Tumorlocatedatthegastricantrumin2cases，gastricbodyin3casesandcardiain6cases．Livermetastaseswerefoundin5patients．Sevenpatientsreceivedsurgery，inwhich4caseshadpalliativeresection，3caseshadcurativeresection．Lymphnodemetastaseswerefoundinthese7patients．Twopat

6、ientswerestageⅢ，9patientswerestageⅣaccordingtoclinicopathologicstagingcriterion．Fivepatientswithsurgeryand3patientswithoutsurgeryreceivedchemo-therapywithorwithoutinterventionaltherapy．Generallytheprognosisofthesepatientswaspoor，4patientsdiedwithOSof1～10months．ConclusionHepatoidade

7、nocarcinomaofstomachisanindependentspecificentitywithpoorprogno-sis．LymphnodemetastasisandlivermetastasisarecommoninHAS．SpecialattentionshouldbepaidtoHAS．Keywords:stomachneoplasmshepatoidadenocarcinomaalphafetoproteindiagnosistherapyOncolProg，2012，10(2)#通信作者(Correspondingauthor)，e-

8、mail:li．xiaoyi@263．netONCO