摘要
目的探讨结直肠浸润性微乳头状癌(invasive micropapillary carcinoma,IMPC)的临床病理学特征及免疫组化表型。方法对11例结直肠IMPC进行HE染色及免疫组化SP法染色,观察其临床病理学特征及免疫表型。结果 11例IMPC中,男性6例,女性5例,年龄26～83岁,中位数61岁,平均59.3岁。9例发生于直肠,2例发生于降乙结肠交界处。肿瘤最大径1.5～6.5 cm,大体形态:溃疡型6例,隆起溃疡型5例。镜检:IMPC成分在整个肿瘤中所占的比率均>90%,其中5例为纯IMPC。全部病例均检出脉管内癌栓、肠系膜淋巴结转移;术中发现肝脏转移3例,广泛腹膜转移1例,左侧腹股沟淋巴结转移1例。2例术后6个月死于肿瘤;1例术后8个月发现子宫腔癌转移、12个月死于肿瘤;1例术后36个月肝脏转移;4例术后6～38个月无瘤生存;3例失访。结论结直肠IMPC是一种高度恶性肿瘤,具有高度侵袭性、高脉管侵犯率、高淋巴结及远处转移率,预后差;应与淋巴管内癌栓、转移性肿瘤相鉴别。
Purpose To investigate the clinicopathological features and imnmnohistochemical phenotypes of invasive micropapillary carcinoma （IMPC） of colorectum. Methods HE staining and immunohistochemistry were used to observe the clinlcopathological fea- tures and immunohistochemical phenotypes in 11 cases of colorectal invasive micropapillary carcinoma. Results In the 11 cases of colorectal IMPC, 6 were males and 5 were females. The age ranged from 26 to 83 years （ median 61, average 59.3 ）. 9 tumours loca- ted in rectum and 2 located in the junction of descending and sigmoid colon. The maximum diameter of the tumours ranged from 1.5 cm to 6. 5 em. 6 tumours showed ulcerating shape and 5 turnouts showed ulcerated fungating shape. Microscopically, all the carcinomas were mainly composed of atypical cells arranged in micropapillary structures. 5 of them were purely invasive micropapillary carcinoma. There were lymphatic invasion and venous invasion in all cases. Regional lymph nodes revealed metastases in all cases. During the op- eration, metastases to the liver in 3 cases, peritoneal dissemination in 1 case, metastases to the left inguinal lymph nodes in 1 case were detected. 6 months after operation 2 patients died. 8 months after operation IMPC metastased to the uterus in one case and 4 months later the patient died. 36 months after operation IMPC metastased to the liver in one case. 6 - 38 months after operation 4 pa- tients were survived with free of tumours. 4 patients were lost in follow-up after operation. Conclusion Colorectal invasive micropapil- lary carcinoma is a highly malignant carcinoma. It is associated with a poor prognosis and has a high incidence of lymph node metasta- sis, lymphatic invasion, venous invasion and distant metastasis. Tumor thrombi in the lymphatic and venous, metastatic carcinoma must be considered in the differential diagnosis.
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2012年第12期1336-1341,共6页
Chinese Journal of Clinical and Experimental Pathology
关键词
结直肠肿瘤
微乳头状癌
浸润
转移
免疫组织化学
colorectum neoplasms
micropapillary carcinoma
invasion
metastasis
immunohistochemistry
