论文部分内容阅读
目的 :旨在加深对产甲胎蛋白胃癌 (alpha fetoprotein producinggastriccarcinoma,AFPGC)的诊断、治疗及预后的认识。方法 :回顾性复习 2 0 0 1年 11月～ 2 0 0 2年 6月 87例血清甲胎蛋白 (AFP)升高的住院患者病历资料 ,对其中诊断为胃癌患者的手术标本进行苏木精 -伊红 (HE)染色及免疫组化染色。总结有关资料并复习相关文献。结果 :血清AFP高于正常水平的患者中 ,2例病理诊断为胃肝样腺癌。AFP、癌胚抗原 (CEA)、α1 抗胰蛋白酶 (α1 AT)、α1 抗胰糜蛋白酶 (α1 ACT)等免疫表型均呈阳性。常规化疗不能控制疾病进展 ,2者均出现肝转移。结论 :AFPGC具有高度侵袭性 ,易出现肝转移 ,预后差。治疗首选胃癌根治术 ,术后推荐使用以丝裂霉素、伊立替康等为主的方案行辅助化疗 ,但仍有待发现更新的AFPGC综合治疗模式
Objective: To deepen the understanding of the diagnosis, treatment and prognosis of alpha fetoprotein producing gastric cancer (AFPGC). Methods: The clinical data of 87 hospitalized patients with elevated serum alpha-fetoprotein (AFP) from November 2001 to June 2012 were retrospectively reviewed. The surgical specimens of patients diagnosed with gastric cancer were treated with hematoxylin - Eosin (HE) staining and immunohistochemical staining. Summarize the relevant information and review the relevant literature. Results: Among the patients with serum AFP higher than normal level, 2 cases were pathologically diagnosed as adenocarcinoma of the stomach and the liver. AFP, carcinoembryonic antigen (CEA), α1 antitrypsin (α1 AT), α1 anticholysin (α1 ACT) and other immunophenotypes were positive. Conventional chemotherapy can not control the progress of the disease, 2 were liver metastases. Conclusion: AFPGC is highly invasive, prone to liver metastasis, poor prognosis. The treatment of choice for radical gastrectomy, postoperative recommended mitomycin, irinotecan-based programs such as adjuvant chemotherapy, but remains to be found in the new AFPGC comprehensive treatment model