摘要
目的探讨胃底腺型腺癌(GA-FG)患者的病理特征。方法回顾分析本院5例GA-FG患者的资料,所有患者均进行病理检查。分析患者的临床特征、内镜特征、病理特征与免疫表型、分化类型与病理特征。结果①5例患者中,男性患者多于女性,年龄均在60岁以上,症状表现为上腹部轻微疼痛或不适、反酸、嗳气、呕血或黑便。②患者病变位置以胃底、胃体部为主,肿直径在0.3~1.2 cm,浸润深度50~500μm。③内镜下观察显示,病灶主要向黏膜下层浸润,形态学分型以0~Ⅱa型为主。病理组织学上可见腺体结构紊乱、排列密集,细胞多呈柱状或圆锥形。免疫组织化学检测结果提示CgA阳性表达,CD56与Syn呈弥漫阳性表达。④在不同的分化类型上,主细胞为主型3例,壁细胞为主型1例,混合型1例,均未出现复发或转移情况。结论GA-FG发病率低、罕见,肿瘤多位于胃底、胃体,浸润黏膜下层。通过对病理组织学形态、内镜特征、免疫表型的分析,能够为临床鉴别诊断和预后评估提供可靠参考。
Objective To explore the pathological characteristics of patients with gastric adenocarcinoma of the fundic gland type(GA-FG).Methods A retrospective analysis was conducted on the data of 5 GAFG patients,and all patients underwent pathological examination.Clinical characteristics,endoscopic features,pathological characteristics,and immunophenotypes were analyzed,along with differentiation types and pathological features.Results(1)Among the 5 patients,there were more male patients than female patients,all aged 60 years,with symptoms including mild upper abdominal pain or discomfort,acid reflux,belching,and hematemesis or melena.(2)The patient's lesions were mainly located in the fundus and body of the stomach,with a maximum tumor diameter of 0.3-1.2 cm and an infiltration depth of 50-500μm.(3)Endoscopic observation showed that the lesion mainly infiltrates into the submucosal layer,and the morphological classification was mainly type 0-Ⅱa.Pathological histology showed that the glandular structure was disordered and densely arranged,with cells mostly in the shape of columns or cones.The immunohistochemical test results indicated possitive expression of CgA,and CD56 and Syn showed diffuse positive expression.(4)On different types of differentiation,there were 3 cases of chief cell-predominant type,1 case of parietal cell-predominant type,and 1 case of mixed type,and no recurrence or metastasis occurred.Conclusion The incidence rate of GA-FG is low and rare.Most of the tumors are located in the fundus and body of the stomach and infiltrate the submucosa.By analyzing histopathological morphology,endoscopic features,and immunophenotypes,reliable references can be provided for clinical diagnosis,differential diagnosis,and prognosis evaluation.
作者
杨瑞东
YANG Rui-dong(Luanzhou People's Hospital,Luanzhou 063700,China)
出处
《中国实用医药》
2026年第4期41-44,共4页
China Practical Medicine
关键词
胃底腺型腺癌
临床特征
病理特征
Gastric adenocarcinoma of the fundic gland type
Clinical features
Pathological features
