| 吴灿,黄友信.胃髓样癌伴丰富淋巴细胞浸润 17例的临床病理特征分析及文献复习[J].安徽医药,2026,30(10):2066-2069. |
| 胃髓样癌伴丰富淋巴细胞浸润 17例的临床病理特征分析及文献复习 |
| Clinical and pathological characteristics analysis and literature review of 17 cases of gastric medullary carcinoma with rich lymphocytic infiltration |
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| DOI：10.3969/j.issn.1009-6469.2026.10.030 |
| 中文关键词: 胃肿瘤 癌，髓样 淋巴细胞，肿瘤浸润 淋巴上皮瘤样癌 EB病毒 三级淋巴结构 病理学 临床 |
| 英文关键词: Carcinoma,medullary Lymphocytes,tumor-Infiltrating Gastric neoplasms Lymphoepithelioma-like carcinoma Ep-stein-Barr virus Tertiary lymphoid structures Pathology Clinical |
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| 中文摘要: |
| 目的探讨胃髓样癌伴丰富淋巴细胞浸润( GMLS)即传统所称的胃淋巴上皮瘤样癌( GLELC)的临床病理特征及诊断要点。方法采用回顾性研究方法，收集2021年8月至2025，年 7月中国科学技术大学附属第一医院收治的 17例原发性 GMLS病例，分析其临床资料、组织学形态、免疫表型及 EB病毒编码的 RNA(Epstein-Barrvirus-encodedRNA，EBER)原位杂交结果，并结合文献进行讨论。结果 17例病人中男性居多( 13例)，中位年龄 65岁。肿瘤好发于近端胃。组织学上，所有病例均表现为特征性的髓样癌形态伴大量淋巴细胞浸润及三级淋巴结构形成，其中包含罕见的胃原发鳞状细胞癌( 1例)和腺鳞癌( 1例)亚型。所有病例 EBER检测均呈阳性。结论胃髓样癌伴丰富淋巴细胞浸润是一种与 EB病毒密切相关的特殊类型胃癌。该研究通过 17例详细分析，揭示了其包含鳞状分化等少见亚型的形态谱系，强调了结合形态、免疫组织化学法及 EBER检测进行综合诊断的重要性，其独特的肿瘤免疫微环境(富含三级淋巴结构)可能预示较好的临床预后。 |
| 英文摘要: |
| Objective To investigate the clinicopathological features and key diagnostic points of gastric medullary carcinoma withlymphoid stroma (GMLS), historically referred to as gastric lymphoepithelioma-like carcinoma (LELC).Methods A retrospective analy-sis was performed on 17 cases of primary GMLS diagnosed at the First Affiliated Hospital of USTC from August 2021 to July 2025. Clini-cal data, histopathological features, immunophenotypes, and Epstein Barr virus encoded small RNA (EBER) in situ hybridization results were collected and analyzed in conjunction with a review of the relevant literature.Results Among the 17 patients, males pre-dominated (13 cases), with a median age of 65 years. Tumors predominantly involved the proximal stomach. Histologically, all cases ex-hibited a medullary carcinoma morphology with a prominent lymphocytic infiltrate and tertiary lymphoid structures. Among them, thereis one case of rare primary gastric squamous cell carcinoma, and one case of adenosquamous carcinoma. EBER in situ hybridizationyielded positive nuclear signals in all 17 cases.Conclusions GMLS is a distinct subtype of gastric carcinoma strongly associated with Epstein Barr virus infection. This detailed analysis of 17 cases reveals a morphological spectrum including rare subtypes with squa-mous differentiation, emphasizing the importance of comprehensive diagnosis combining morphology, immunohistochemistry, and EBERdetection. The unique tumor immune microenvironment (rich in tertiary lymphoid structures) may predict a favorable clinical prognosis. |
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