Poorly differentiated solid type adenocarcinomas in the stomach: A clinicopathologic study of 71 cases
Poorly differentiated solid type adenocarcinomas in the stomach: A clinicopathologic study of 71 cases
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胃低分化实性腺癌71例临床病理分析
DOI：
10.1002/jso.2930510204
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发表时间：
1992
影响因子：
2.5
通讯作者：
John S. Meyer
中科院分区：
文献类型：
--
作者：
T. Ueyama;M. Tsuneyoshi;John S. Meyer
对从 2,738 例手术切除的低分化腺癌 (PDA) 病例中选出的 71 例胃实体癌进行了回顾。患者的平均年龄为 62 岁，其中包括 47 名男性和 24 名女性。实体癌的临床病理特征与分化型腺癌相似。实体癌分为实性肺泡型42例和游离细胞型29例；前者中有 32 个（76%）具有明显分化区域的病灶，而后者大多数缺乏这种病灶并具有一些印戒细胞。许多这两种类型的肿瘤即使在侵袭早期也具有明显的静脉渗透和淋巴结转移。所有病例的 5 年生存率为 37%，其中有限浸润粘膜下层或固有肌层的癌病例为 44%，癌浸润至浆膜下层的病例为 27%。与选择作为对照的 110 例普通 PDA（Lauren 弥漫型）病例相比，这些存活率较低。这些发现表明，实性肺泡型肿瘤是由分化型腺癌转化而来，而游离细胞型肿瘤最初是由PDA转化而来。也有人认为，实体癌确实表现出较高的静脉渗透和淋巴结转移发生率，且此类癌症的预后较差。 © 1992 Wiley-Liss, Inc.
A review of 71 cases of solid carcinoma of the stomach selected from 2,738 cases of surgically resected poorly differentiated adenocarcinomas (PDAs) was undertaken. The average age of the patients, which included 47 men and 24 women, was 62 years. The clinicopathologic features of solid carcinomas were similar to those of the differentiated type adenocarcinomas. The solid carcinomas were divided into 42 of the solid alveolar type and 29 of the free‐cell type; 32 of the former (76%) had foci of overt differentiated areas, while most of the latter type lacked such foci and had some signet‐ring cells. Many tumors of both types had a prominent venous permeation and lymph node metastasis even in the early stage of invasion. The 5‐year survival rates were 37% in all cases, 44% in cases with carcinoma with a limited invasion of the submucosa or the muscularis propria, and 27% in carcinoma invading down to the subserosa. These survival rates were poor in comparison with the 110 cases of ordinary PDA (diffuse type of Lauren) selected as controls. These findings suggest that tumors of the solid alveolar type are transformed from the differentiated type of adenocarcinoma, while those of the free‐cell type are originally from PDAs. It is also suggested that solid carcinomas did show a high incidence of venous permeation and lymph node metastasis and that the prognosis for this type of carcinoma is poor. © 1992 Wiley‐Liss, Inc.