目的探讨胃肝样与非肝样腺癌的临床病理差异．方法以胃肝样腺癌（２４例）为研究对象，以胃非肝样腺癌（１１２８例）为对照组，由２名以上作者对全部病例的临床病理资料进行回顾性分析．采用放射免疫双抗法和ＡＢＣ免疫组化法检测９５６例（含部分门诊病例）胃癌患者血清ＡＦＰ和４５例石蜡包埋胃癌组织中的ＡＦＰ及ＣＥＡ．对１４０例胃癌患者术后进行了随访．结果对比行卡方检验．结果脉管浸润率、术前肝及其它脏器转移率和术后１年死亡率胃肝样腺癌组和非肝样腺癌组分别为７５００％，２０８３％，８３３％，５０００％及５３３２％，１６０％，０８０％，２８４５％．前组明显高于后组（Ｐ＜００５，Ｐ＜００１）．而发病年龄、性别分布、好发部位及大体类型两组相似．淋巴结转移率无显著性差异（Ｐ＞００５）．结论胃肝样腺癌比一般类型胃癌在生物学行为上更易浸润腺管，肝转移率高，预后差． 3. Objective To explore the clinicopathologic differences between hepatic and non - hepatic adenocarcinoma. Methods Gastric hepatoid adenocarcinoma (24 cases) as the research object, and non-hepatic adenocarcinoma of the stomach (1128 cases) as the control group. The clinical and pathological data of all cases were retrospectively analyzed by 2 or more authors. Radioimmunoassay and ABC immunohistochemistry were used to detect serum AFP in 956 patients (including some outpatients) and AFP and CEA in 45 paraffin-embedded gastric cancer tissues. The postoperative follow-up of 140 patients with gastric cancer was performed. The results were compared with the chi-square test. Results Vascular infiltration rate, preoperative liver and other organ metastasis rates, and postoperative 1-year mortality rates were 75% in the hepatoid adenocarcinoma group and non-hepatoid adenocarcinoma group, respectively. %, 5000% and 5332%, 160%, 080%, 2845%. The former group was significantly higher than the latter group (P<005, P<001). The onset age, gender distribution, predilection site and general type were similar in both groups. There was no significant difference in lymph node metastasis (P>005). Conclusion Gastric liver-like adenocarcinoma is more infiltrating into the duct than the common type of gastric cancer. The liver metastasis rate is high and the prognosis is poor.