Pancreatic (Acinar) Metaplasia of the Gastric Mucosa: Histology, Ultrastructure, Immunocytochemistry, and Clinicopathologic Correlations of 101 Cases
Pancreatic (Acinar) Metaplasia of the Gastric Mucosa: Histology, Ultrastructure, Immunocytochemistry, and Clinicopathologic Correlations of 101 Cases
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胃粘膜胰（腺泡）化生：101 例的组织学、超微结构、免疫细胞化学和临床病理相关性
DOI：
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发表时间：
1993
影响因子：
5.6
通讯作者：
G. Viale
中科院分区：
文献类型：
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作者：
C. Doglioni;L. Laurino;A. D. Dei Tos;M. de Boni;G. Franzin;P. Braidotti;G. Viale
在胃粘膜内偶然发现形态特征与胰腺腺泡细胞非常相似的不明上皮细胞，这促使我们对8，430例连续胃活检和126例胃切除术和全胃切除术的手术标本进行回顾性研究。本研究的目的是从形态学和免疫细胞化学的特点，这些细胞，以确定其实际的患病率在一个大系列的乳腺癌病例，并评估其发生的临床病理相关性。101例（84例胃活检和17例胃切除术）胰腺腺泡样细胞，其特征是胞浆丰富，顶部和中部嗜酸性，颗粒细小，基底部嗜碱性。这些细胞排列在胃腺之间的巢状或大小不一的小叶中，光镜和电镜下与胰腺腺泡细胞在形态上难以区分。此外，它们对胰脂肪酶和胰蛋白酶原始终呈免疫反应性，75%的病例对胰α-淀粉酶呈免疫反应性。这些细胞在胃粘膜内的出现与慢性胃炎（p = 0.032）和肠型和幽门型胃化生（p = 0.021）的同时发生显著相关。结果表明，这是一个以前未被认识的胰腺（腺泡）化生的胃粘膜，临床和形态学不同于胰腺异位。
The occasional finding within the gastric mucosa of unidentified epithelial cells with morphological features closely resembling those of pancreatic acinar cells has prompted us to investigate a retrospective series of 8,430 consecutive gastric biopsies and of 126 surgical specimens of gastric resection and total gastrectomy. The aims of the study were to morphologically and immunocytochemically characterize these cells, to define their actual prevalence in a large series of unselected cases, and to assess the clinicopathologic correlates of their occurrence. Pancreatic acinar-like cells characterized by abundant cytoplasm, which was acidophilic and finely granular in the apical and middle portions and basophilic in the basal compartment, have been identified in 101 cases (84 gastric biopsies and 17 gastrectomies). These cells, arranged in nests or in variably sized lobules among the gastric glands, were morphologically indistinguishable from pancreatic acinar cells, both by light and by electron microscopy. Furthermore, they were consistently immunoreactive for pancreatic lipase and trypsinogen and, in 75% of the cases, for pancreatic α-amylase. The appearance of these cells within the gastric mucosa was correlated significantly with chronic gastritis (p = 0.032) and with the simultaneous occurrence of intestinal and pyloric types of gastric metaplasia (p = 0.021). The findings indicate that this is a previously unrecognized pancreatic (acinar) metaplasia of the gastric mucosa, clinically and morphologically distinct from pancreatic heterotopia.