摘要
目的:探讨对产生AFP的癌(除外肝细胞癌和卵黄囊瘤)的组织发生和类型、诊断和鉴别诊断、治疗和预后。方法:对1例发生于胰腺产生AFP的癌的患者的病理组织学、免疫表型进行观察,结合临床资料进行分析并复习相关文献。结果:根治术后,诊断为胰腺内分泌癌合并肝样型癌,其组织学特点是肝样型癌与内分泌癌相互移行、交替排列。前者表达AFP,后者表达CgA和Syn。术后3月发生肝转移。结论:产生AFP的癌的分为四个亚型。各个亚型可以单独出现,也可以与该脏器的原发性癌合并出现。诊断主要靠病理组织学和免疫组织化学确诊,主要与肝细胞癌和卵黄囊瘤鉴别。此类肿瘤具有特殊的组织发生和临床生物学行为,由于AFP有免疫抑制作用,易发生肝转移,属高度恶性肿瘤。
Objective： To study the histogenesis and type, diagnosis and differential diagnosis, treatment and prognosis of AFP-producing carcinomas exclusive of hepatoceUular carcinoma and Yolk Sac malignant tumor. Methods： The clinical data and pathologic material of a women patient with pancreatic AFP-producing carcinoma were reviewed. The sample of tumor was examined by means of HE and immunohistochemistry staining, and the related literature was reviewed. Results： The diagonosis of the tumor was pancreatic endocrine carcinoma occurred with hepatoid type carcinoma. The pathological characteristics of the tumor were composed of two different but closely related areas： hepatoid type carcinoma and edocrine carcinoma region. The former was positive staining for AFP, and the latter for CgA and Syn. After the radical operation, the tumor metastasized to liver. Conclusion： AFP-producing carcinomas are divided into four subtypes. Each type can occur alone or concurrently suffer with primary carcinoma of the same organ. The diagnosis is mainly depended on pathology and immunohistochemical markers. HepatoceUular and Yolk Sac malignant tumor should be looked as principal diseases in differential diagnosis. Because of the immunosuppresant effect of AFP, AFP-producing carcinomas are highly malignant and have special histogenesis and clinical biological behaviors, and easily metastasize to liver.
出处
《肿瘤预防与治疗》
2008年第1期69-72,116,共5页
Journal of Cancer Control And Treatment
关键词
胰腺
产生AFP的癌
组织发生
治疗
预后
Pancreas
AFP-producing Carcinoma
Histogenesis
Diagnosis, Differential
Treatment
Prognosis
