Gastric adenocarcinoma with chief cell differentiation
Gastric adenocarcinoma with chief cell differentiation
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DOI：
10.1111/j.1440-1827.2007.02134.x
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发表时间：
2007-08-01
影响因子：
2.2
通讯作者：
Tatematsu, Masae
中科院分区：
文献类型：
--
作者：
Tsukamoto, Tetsuya;Yokoi, Takio;Tatematsu, Masae
一个病例腺癌与主细胞分化，一个新的实体在胃，提出。一名82岁的女性患者接受远端胃切除术，计划进行上消化道内镜检查以明确机械性肠梗阻。在残胃的贲门处发现一个大小为16 x 14 x 9 mm的突出肿瘤。组织学检查显示为分化良好的管状腺癌，由嗜碱性柱状或立方细胞组成，偶见粗嗜酸性颗粒。免疫组化分析显示胃蛋白酶原I和II和Runt相关转录因子基因3（RUNX 3）的强表达，主细胞的特征，粘液颈细胞的典型MUC 6。然而，肿瘤细胞的质子泵α亚单位（壁细胞的标志物）呈阴性。Cdx 2和防御素-5不存在，证实缺乏肠道表型。癌细胞具有主细胞和粘液颈细胞的特征，类似于这两种细胞类型的祖先，即所谓的胃底腺中的“原始主细胞”。根据这些数据，该癌症被诊断为具有主细胞分化的腺癌。
A case of adenocarcinoma with chief cell differentiation, a novel entity in the stomach, is presented. An 82-year-old woman who had undergone distal gastrectomy, was scheduled for upper gastrointestinal endoscopy to clarify mechanical ileus. A protruding tumor 16 x 14 x 9 mm in size was found in the cardia of the remnant stomach. Histological examination indicated a well-differentiated tubular adenocarcinoma composed of basophilic columnar or cuboidal cells with occasional coarse eosinophilic granules. Immunohistochemical analysis revealed strong expression of pepsinogens I and II and Runt-related transcription factor gene 3 (RUNX3), characteristic for chief cells, and MUC6 typical for mucous neck cells. However, the tumor cells were negative for the proton pump alpha subunit, a marker for parietal cells. Cdx2 and defensin-5 were not present, confirming the lack of an intestinal phenotype. The cancer cells shared characteristics of a chief cell and a mucous neck cell, resembling an ancestor of these two cell types, so-called 'primitive chief cell' in fundic gland. In line with these data, the cancer was diagnosed as an adenocarcinoma with chief cell differentiation.