摘要
目的分析总结胃淋巴上皮瘤样癌（LELGc）的临床病理特征、免疫表型及预后。方法回顾性分析4例男性LELGC患者的临床、影像学和病理组织学资料。采用EB病毒编码的小分子RNA（EBER）原位杂交和免疫组织化学方法检测细胞角蛋白（CK）、CD20、CD3、CD4、CD8、上皮钙黏素、β-连环蛋白、bcl-2、p16、p53、p63、c-erbB-2、细胞周期蛋白D1、Ki67、DNA甲基化转移酶1（DNMTl）蛋白在肿瘤细胞内的表达情况。结果4例患者肿瘤大小分别为1．8cmX1．6cm、1．5cmX2．0cm、2．5cmX2．0cm和4．0cm×2．5cm。光学显微镜下肿瘤细胞呈条索状、小团状或单个散在浸润，细胞核呈空泡状，核仁明显，间质见明显的淋巴细胞浸润。免疫组织化学检测结果提示，4例患者肿瘤中，肿瘤细胞细胞膜CK均阳性着色，细胞核EBER均阳性着色；CD3阳性淋巴细胞数〉CD20阳性数，尤以CD8阳性淋巴细胞为主。4例患者肿瘤细胞胞膜上皮钙黏素、p连环蛋白阳性着色比例在10％～90％之间，且2例存在p连环蛋白细胞质着色；DNMTl、细胞周期蛋白D1、bcl-2均为阳性，p16、c-erbB-2均为阴性。仅1例p63表达阳性，1例p53表达阴性，Ki67指数分别为40％、15％、60％、40％。结论LELGC具有较好的预后，其临床病理及免疫组织化学表达特征有助于做出正确诊断。
Objective To immunophenotype and prognosis analyze and summarize the of the lymphoepithelioma-like gastric clinical-pathological features, carcinoma （LELGC）. Methods The clinical, radiographic and histological data of four patients with LELGC were retrospectively analyzed. The expression of cytokeratin （CK）, CD20, CD3, CD4, CD8, E-cadherin, β-catenin, bcl-2, p16, p53, p63, c-erbB-2,cyclin D1, Ki67 and DNA methyl-transferase 1 （DNMT1） in tumor was detected by Epstein- Barr virus-encoded small RNA （EBER） in situ hybridization and immunohistochemical methods. Results The size of four tumor was 1.8 cm×l.6 cm, 1.5 cm×2.0 cm, 2.5 cm×2.0 cm and 4.0 cmX2.5 cm. Under light microscope, tumor cells appeared like cords, small lumps or scattered single infiltration with vacuolized nucleus; clear nucleoli and obvious interstitial lymphocytic infiltration. The results of immunohistochemical examination indicated that in four tumors CK was positive in membrane of all the tumor cells, while EBER was positive in all cell nucleus. The number of lymphocytes with CD3 positive was over those with CD20 positive, which was mainly CD8 positive lymphocytes. The percentage of E-cadherin and β-catenin positive in the cell membrane of four tumors was between 10% and 90% ,and two cases with β-catenin positive in cytoplasm. The expressions of DNMT1, cyclin D1 and bcl-2 were all positive, while p16 and c-erbB-2 were all negative. The expression of p63 was positive in only one case, and p53 was negative in one case. The percentage of Ki67 positive was 40%, 15%, 60% and 40%, respectively. Conclusions LELGC is a rare neoplasm with better prognosis. The features of clinical pathology and immunohistology may help to make a correct diagnosis.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2014年第3期160-163,共4页
Chinese Journal of Digestion
关键词
胃肿瘤
淋巴上皮瘤样癌
免疫组织化学
病理学
临床
原位杂交
疱疹病毒4型
人
Stomach neoplasms
Lymphoepithelioma-like carcinoma
Immun0histochemistry
Pathology, clinical
In situ hybridization
Herpesvirus 4, human
