Gastric Adenocarcinoma in Common Variable Immunodeficiency: Features of Cancer and Associated Gastritis May Be Characteristic of the Condition
Gastric Adenocarcinoma in Common Variable Immunodeficiency: Features of Cancer and Associated Gastritis May Be Characteristic of the Condition
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DOI：
10.1177/1066896914532540
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发表时间：
2014-10-01
影响因子：
1.2
通讯作者：
Chang, Yu-Hui H.
中科院分区：
文献类型：
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作者：
De Petris, Giovanni;Dhungel, Bal M.;Chang, Yu-Hui H.
常见变异型免疫缺陷（CVID）与胃癌风险增加相关。本研究的目的是确定CVID相关胃腺癌（CAGA）和背景胃炎的形态学特征。研究了2000-2010年期间马约诊所CVID的胃癌患者人群;在研究期间的5793例胃癌患者中发现6例CVID（2例男性，4例女性，平均年龄47岁，年龄范围26-71岁）。每例患者均接受胃切除术，并对其组织学切片进行审查。记录慢性胃炎变量、CVID相关结果和腺癌特征。CAGA为肠型，瘤内淋巴细胞（ITLs）数量较多。胃癌患者的诊断年龄低于胃癌总体人群。4例为重度萎缩性化生性胰腺炎伴广泛异型增生，2例为淋巴细胞性胃炎。6例中4例浆细胞缺乏，4例淋巴结肿大。总之，年轻胃腺癌伴ITL，伴有萎缩性化生性泛红细胞瘤，应提醒病理学家CAGA的可能性。因此，在存在这些特征的情况下，应在非肿瘤组织中进行CVID相关异常的研究。
Common variable immunodeficiency (CVID) is associated with an increased risk of gastric cancer. The aim of the study was to determine the morphological features of CVID-associated gastric adenocarcinoma (CAGA) and of the background gastritis. The population of gastric cancer patients with CVID of Mayo Clinic in the period 2000-2010 was studied; 6 cases of CVID (2 males, 4 females, average age 47 years, age range 26-71 years) were found in 5793 patients with gastric cancer in the study period. Each patient underwent gastric resection for which histology slides were reviewed. Chronic gastritis variables, CVID-related findings, and features of the adenocarcinoma were recorded. CAGA was of intestinal type, with high number of intratumoral lymphocytes (ITLs). Cancer was diagnosed in younger patients than in the overall population of gastric cancer. Severe atrophic metaplastic pangastritis with extensive dysplasia was present in the background in 4 cases, with features of lymphocytic gastritis in 2 cases. Features of CVID (plasma cells paucity in 4 of 6 cases, lymphoid nodules prominent in four cases) could be detected. In summary, gastric adenocarcinoma at young age with ITLs, accompanied by atrophic metaplastic pangastritis, should alert the pathologist of the possibility of CAGA. It follows that, in presence of those characteristics, the search of CVID-associated abnormalities should be undertaken in the nonneoplastic tissues.