| 汪元元,翁海燕.胃肠道杯状细胞腺癌 10例临床病理分析[J].安徽医药,2026,30(3):585-589. |
| 胃肠道杯状细胞腺癌 10例临床病理分析 |
| Clinicopathological analysis of 10 cases of gastrointestinal goblet cell adenocarcinoma |
| |
| DOI：10.3969/j.issn.1009-6469.2026.03.031 |
| 中文关键词: 类癌瘤 阑尾杯状细胞腺癌 胃 结肠 直肠 病理 |
| 英文关键词: Carcinoid tumor Appendiceal goblet cell adenocarcinoma Stomach Colon Rectum Pathology |
| 基金项目: |
|
| 摘要点击次数: 336 |
| 全文下载次数: 172 |
| 中文摘要: |
| 目的深入探讨原发性胃肠道杯状细胞腺癌(GCA)的临床病理特征。方法收集 2020年 11月至 2023年 6月在中国科学技术大学附属第一医院(安徽省立医院)术后病理诊断为 GCA病例并在临床病理库中分析查找相关资料。根据 2019年第 5版世界卫生组织( WHO)阑尾 GCA诊断标准，由 2位具有高级职称的病理科医师进行独立阅片，并分析各例的临床病理资料、预后情况。结果共筛查出 10例，其中阑尾 GCA 8例，胃 GCA 1例，直肠 GCA 1例；男性 4例，女性 6例；年龄范围为 26~67岁。其中 4例术前诊断为急性阑尾炎，术后病理诊断为阑尾 GCA，二次追加右半结肠切除术； 1例术前诊断为回盲部肿物，行右半结肠切除术； 1例行单纯阑尾切除术，切缘阴性。 8例阑尾 GCA病人， 3例为 Ⅰ期肿瘤， 2例为 ⅢC期， 3例为 Ⅳ期。胃及直肠 GCA均为 ⅣB期肿瘤。共 7例病人为晚期肿瘤。组织学方面:肿瘤细胞呈小簇状、巢片状弥漫浸润固有肌层，直肠 GCA局部见神经内分泌癌与 GCA混合，胃 GCA肿瘤细胞弥漫浸润性生长，细胞中等异型性，相互融合呈巢片状，细胞外黏液丰富。免疫组织化学方面: 7例阑尾 GCA表达突触素( 7/7)，4例表达嗜铬粒蛋白 A(CgA)(4/7)3例表达神经细胞黏附分子( CD56)(3/6)；胃及直肠 GCA中表达突触素、 CgA、CD56、细胞角蛋白(CK)、CK20、肠特异性转录因子2(，CDX-2)而直肠 GCA中表达黏蛋白 2(MUC-2)、特异 AT序列结合蛋白 2(SATB2)。结论胃肠道 GCA是罕见的特殊类型的胃肠道肿瘤，，以阑尾多见，亦可发生在胃及结直肠，临床上多为偶发，症状及体征特异性不强，但病理学方面具有独特的表现，正确认识该疾病对临床治疗、改善预后有重要意义。 |
| 英文摘要: |
| Objective To thoroughly explore the clinicopathological characteristics of primary gastrointestinal goblet cell adenocarci. noma (GCA).Methods Cases pathologically diagnosed as GCA postoperatively at the First Affiliated Hospital of University of Scienceand Technology of China (Anhui Provincial Hospital) from November 2020 to June 2023 were collected, and relevant data were re.trieved from the clinicopathological database for analysis. According to the diagnostic criteria appendiceal GCA in the 2019 WHO Clas.sification (5th edition), two senior pathologists independently reviewed the slides. The clinicopathological data and prognosis of eachcase were analyzed.Results A total of 10 cases were identified, comprising 8 cases of appendiceal GCA, 1 case of gastric GCA, 1 caseof rectal GCA. There were 4 males and 6 females, with an age range of 26 to 67 years. Four cases were preoperatively diagnosed withacute appendicitis; postoperative pathology confirmed appendiceal GCA, and a secondary right hemicolectomy was performed. Onecase was preoperatively diagnosed with an ileocecal mass and underwent right hemicolectomy. One case underwent simple appendecto.my with negative margins. Among the 8 appendiceal GCA cases, tumor stages were as follows: 3 cases were stage Ⅰ, 2 were stage ⅢC,and 3 were stage Ⅳ. Both the gastric and rectal GCAs were stage ⅣB tumors. In total, 7 patients had advanced-stage tumors. Histologi.cally, tumor cells infiltrated the muscularis propria in small clusters and diffuse sheets. In the rectal GCA, a mixed component of neuro.endocrine carcinoma and GCA was observed locally. The gastric GCA exhibited diffusely infiltrative growth of tumor cells with moder.ate atypia, forming confluent nests and sheets within abundant extracellular mucin. Immunohistochemically, among the appendicealGCAs, synaptophysin (Syn) was expressed in 7/7 cases, chromogranin A (CgA) in 4/7 cases, and CD56 in 3/6 cases. The gastric and rec.tal GCAs expressed Syn, CgA, CD56, cytokeratin (CK), CK20, and CDX-2. Additionally, the rectal GCA expressed MUC-2 and SATB2. Conclusions Gastrointestinal GCA is a rare and distinctive type of gastrointestinal tumor, most frequently found in the appendix butalso occurring in the stomach and colorectal. It is often an incidental clinical finding with non-specific symptoms and signs but possessesunique pathological features. A correct understanding of this disease is crucial for guiding clinical management and improving prognosis. |
|
查看全文
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
