中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2011年
8期
596-598
,共3页
武爱文%陕飞%薛卫成%董彬%张连海%李子禹%步召德%吴晓江%宗祥龙%季加孚
武愛文%陝飛%薛衛成%董彬%張連海%李子禹%步召德%吳曉江%宗祥龍%季加孚
무애문%협비%설위성%동빈%장련해%리자우%보소덕%오효강%종상룡%계가부
胃肿瘤%新辅助化疗%病理学完全缓解%间质细胞反应
胃腫瘤%新輔助化療%病理學完全緩解%間質細胞反應
위종류%신보조화료%병이학완전완해%간질세포반응
Stomach neoplasms%Neoadjuvant chemotherapy%Pathological complete response%Stromal cell response
目的 观察胃癌新辅助化疗后原发灶病理学完全缓解(pCR)患者的病理学特征。方法 收集北京肿瘤医院2002-2008年间完成新辅助化疗的胃癌患者病例资料，筛选出原发灶pCR者共5例，复习病理切片，并分别就胃壁的组织结构、肿瘤细胞形态、间质细胞的数量和形态进行分析评价。结果 5例患者胃壁结构均可区分，有2例可见肌层弯折、断裂。1例可见胃壁各层包括浆膜层呈现渗出性炎性表现。3例溃疡型病变，上皮层脱落，溃疡存在，边缘可见不典型增生的细胞改变，间质血管内皮细胞肿胀。仅1例残留变性坏死的癌细胞，其余4例未见癌残留迹象。4例显示成纤维细胞显著增生,3例见大量淋巴细胞浸润,1例同时伴有浆细胞浸润,1例肌层可见多核巨细胞反应,1例黏液腺癌可见泡沫细胞聚集。5例原发灶pCR病例中有2例淋巴结可见癌转移。结论 胃癌新辅助化疗后，原发灶pCR病例肿瘤区域间质细胞反应呈现不均一性，原发灶反应与淋巴结不相一致。
目的 觀察胃癌新輔助化療後原髮竈病理學完全緩解(pCR)患者的病理學特徵。方法 收集北京腫瘤醫院2002-2008年間完成新輔助化療的胃癌患者病例資料，篩選齣原髮竈pCR者共5例，複習病理切片，併分彆就胃壁的組織結構、腫瘤細胞形態、間質細胞的數量和形態進行分析評價。結果 5例患者胃壁結構均可區分，有2例可見肌層彎摺、斷裂。1例可見胃壁各層包括漿膜層呈現滲齣性炎性錶現。3例潰瘍型病變，上皮層脫落，潰瘍存在，邊緣可見不典型增生的細胞改變，間質血管內皮細胞腫脹。僅1例殘留變性壞死的癌細胞，其餘4例未見癌殘留跡象。4例顯示成纖維細胞顯著增生,3例見大量淋巴細胞浸潤,1例同時伴有漿細胞浸潤,1例肌層可見多覈巨細胞反應,1例黏液腺癌可見泡沫細胞聚集。5例原髮竈pCR病例中有2例淋巴結可見癌轉移。結論 胃癌新輔助化療後，原髮竈pCR病例腫瘤區域間質細胞反應呈現不均一性，原髮竈反應與淋巴結不相一緻。
목적 관찰위암신보조화료후원발조병이학완전완해(pCR)환자적병이학특정。방법 수집북경종류의원2002-2008년간완성신보조화료적위암환자병례자료，사선출원발조pCR자공5례，복습병리절편，병분별취위벽적조직결구、종류세포형태、간질세포적수량화형태진행분석평개。결과 5례환자위벽결구균가구분，유2례가견기층만절、단렬。1례가견위벽각층포괄장막층정현삼출성염성표현。3례궤양형병변，상피층탈락，궤양존재，변연가견불전형증생적세포개변，간질혈관내피세포종창。부1례잔류변성배사적암세포，기여4례미견암잔류적상。4례현시성섬유세포현저증생,3례견대량림파세포침윤,1례동시반유장세포침윤,1례기층가견다핵거세포반응,1례점액선암가견포말세포취집。5례원발조pCR병례중유2례림파결가견암전이。결론 위암신보조화료후，원발조pCR병례종류구역간질세포반응정현불균일성，원발조반응여림파결불상일치。
Objective To observe the clinicopathological characteristics of gastric cancer with pathological complete response(pCR) following neoadjuvant chemotherapy. Methods Data of gastric cancer patients who received neoedjuvant chemotherapy from 2002 to 2008 in the Beijing Cancer Hospital were reviewed. Five cases were found to have pCR. The slides were reviewed by two experienced pathologists independently. Histological structure, morphology of tumor cells, morphology and quantity of stromal cells were evaluated. Results Structure of the gastric wall was distinguishable in all the 5 cases, while distortion and rupture of muscular layer were found in 2 cases. Exudative inflammatory reaction was present in the whole gastric wall including the serosa layer. Three patients had ulcerative lesions with epithelial layer shedding, and atypical hyperplasia was found around the border of the ulcer, and vascular endothelial cells were swollen. Residual distorted necrotic tumor cells resided in 1 case only and no residual tumor cells was present in the other 4 patients. Significant hyperplasia of fibroblasts was present in 4 cases, large amount of lymphocytes infiltration in 3 cases including concurrent plasma cell infiltration in 1 case, multinucleated giant cell reaction in the muscular layer of 1 case, and foam cells aggregation in 1 case with mucinous adenocarcinoma. In addition, there were 2 cases with pCR had lymph node metastasis. Conclusions For cases with pCR following neoadjuvant chemotherapy, heterogeneity of stromal cells reaction is found in previous tumor site. Furthermore, the response of primary tumor does not necessarily parallel to that of lymph nodes.
