摘要
目的探讨结肠肝样腺癌的临床病理特征。方法回顾我科1例乙状结肠肝样腺癌的临床资料,行病理组织学和免疫组化观察并复习相关文献。结果结肠肝样腺癌以男性多见,发病年龄以中老年为主,镜下肿瘤常由具有肝细胞样肝癌分化特点和腺癌分化特征的两种类型病变区域组成,交界处可见两种成分细胞间的相互移行,腺癌区以低分化腺癌最为多见,在肝细胞样分化区,分化好的肿瘤细胞呈小梁状或巢状排列,癌细胞大,多边形,核仁大,居中,可见核分裂像,间质脉管内查见大量癌栓。免疫组织化学结果显示AFP、Hep-1部分病例均可阳性,CK8/18、CK19均阳性表达,易于发生血行转移及肝转移,病人随访半年,化疗五次,尚存活。结论结肠肝样腺癌具有明显的侵袭性和高度恶性的生物学特性,临床病理学特点突出,术后复发早、预后差。
Objective To investigate the clinical and pathological features of hepatoid adenocarcinoma of colon.Methods To review a case of hepatoid adenocarcinoma of the sigmoid colon of clinical data and observe the results of pathological histology and immunohistochemical and review related literature.Results Hepatoid adenocarcinoma of the colon was more common in male,and the age of onset was mainly of the middle-aged and elderly.Microscopically,neoplasms often consist of two types of lesion area with differentiation characteristics of hepatocellular carcinoma and adenocarcinoma,the junction can be seen the intermigration of two constituent cells,the adenocarcinoma area is the most commonly seen in poorly differentiated adenocarcinoma,and the differentiated cells are arranged in small girders or nests in the area of hepatocyte-like cells.The cancer cells are large and polygons,the nucleolus is large and centered,the mitotic figures are visible,and the cancer embolus are visible within blood vessels and lymphatics.The results of immunohistochemical show AFP and Hep-1 are part positive,CK8/18 and CK19 are positive.It’s prone to hematogenous and hepatic metastasis.The patient was followed for half a year,with chemotherapy five times and survived.Conclusion Hepatoid adenocarcinoma of the colon is obviously aggressive and highly malignant,the clinical and pathological features are prominent,postoperative recurrence is early and prognosis is poor.
作者
徐慧蓉
王新美
王新云
张保华
崔海燕
孙晓宇
XU Hui-rong;WANG Xin-mei;WANG Xin-yun(Department of Pathology,Zibo Central Hospital,Zibo 255036,Shandong,Province,China)
出处
《罕少疾病杂志》
2019年第4期40-42,2,共4页
Journal of Rare and Uncommon Diseases
关键词
结肠肿瘤
肝样腺癌
AFP
Hep-1
Colon Neoplasms
Hepatoid Adenocarcinoma
Alpha Fetoprotein
Heptocyte-1
