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目的探讨胃原发性绒毛膜上皮癌(PGC)的临床表现及病理形态学特征。方法对3例PGC患者的临床表现、组织形态学特征及免疫组化特点进行分析,并复习相关文献。结果本组3例PGC的临床表现为胃部巨大溃疡型肿块,并伴有胃周围淋巴结及肝转移;3例患者血清β-HCG均异常升高。主要病理形态学表现为呈片状分布的细胞滋养层细胞及合体滋养层细胞,肿瘤细胞异型性明显,并可见大片坏死及出血。免疫组化:肿瘤细胞CK和HCG(+),CEA和AFP(-),Ki-67阳性指数>80%。结论 PGC是一种罕见的高度恶性肿瘤,其典型的临床表现是胃部肿块和血HCG异常升高,并伴有淋巴结及肝转移。PGC需要与胃低分化腺癌鉴别,其预后极差,中位生存期只有数月。
Objective To investigate the clinical manifestations and pathomorphological features of gastric primary choriocarcinoma (PGC). Methods The clinical manifestations, histomorphological features and immunohistochemical features of 3 PGC patients were analyzed and related literatures were reviewed. Results The clinical manifestations of 3 cases of PGC in this group were giant ulcerated gastric mass accompanied by lymph node metastasis and liver metastasis. The serum β-HCG in 3 patients were abnormally elevated. The main histopathological manifestations were patchy distribution of trophoblast cells and syncytiotrophoblast cells, atypical tumor cells were obvious, and visible large necrosis and bleeding. Immunohistochemistry: tumor cells CK and HCG (+), CEA and AFP (-), Ki-67 positive index> 80%. Conclusions PGC is a rare and highly malignant tumor. The typical clinical manifestation is abnormal increase of gastric mass and blood HCG accompanied by lymph node and liver metastasis. PGC needs to be differentiated from poorly differentiated adenocarcinoma of the stomach and has a very poor prognosis with a median survival of only a few months.