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- Micropapillary Carcinoma of Stomach（胃微乳头状癌）
Micropapillary Carcinoma of Stomach:A Clinicopathologic and Immunohistochemical Study of 11 Cases
Am J Surg Pathol 2010;34:1139–1146.
Abstract
Micropapillary carcinoma (MPC) of the stomach is a rare, newly recognized entity, and only 2 patients with this histology have been reported. We investigated clinicopathologic features, expression of mucin (MUC2, MUC5AC, MUC6, CD10) and cytokeratin profiles (CK7 and CK20), epidermal growth factor receptors (EGFR and HER2), prognostic markers (p53 and Ki-67), and outcomes in 11 MPCs of the stomach. The proportion of MPC component ranged from 5% to 70%. Micropapillary features were often found at the deep advancing edge of the tumor. Endolymphatic tumor emboli were found in 10 cases (91%) and lymph node metastases were found in 4 cases (36%). In MPCs, positive expression was observed for Ki-67 (82%), CK7 (73%), EGFR (64%), p53 (64%), MUC5AC (45%), MUC6 (36%), and CK20 (27%). However, MUC2, CD10, and HER2 expression was negative in all cases. In 9 conventional adenocarcinomas and 11 papillary adenocarcinomas with multiple endolymphatic tumor emboli, used as control, positive expression was observed for Ki-67 (100%), CK7 (90%), EGFR (80%), CK20 (70%), p53 (70%), MUC5AC (70%), MUC6 (60%), MUC2 (40%), CD10 (25%), and HER2 (15%). Expression of MUC2, CK20, and the Ki-67 labeling index was significantly higher in control adenocarcinomas as compared with MPCs (P<0.05). However, there was no significant difference in other clinicopathologic features and overall patient survival. Subclassification of MPCs into 2 subgroups according to the proportion of micropapillary component (cut-off value was 20%) failed to find any significant clinicopathologic differences (P>0.05). Although MPCs in other organs show a poor prognosis, this does not seem to be true for gastric MPCs. Further larger studies are necessary to confirm our initial findings.
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标签：
- The More We See, The Less We Know!
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Am J Surg Pathol. 2011 Jan;35(1):84-91.
Gastric micropapillary carcinoma: A distinct subtype with a significantly worse prognosis in TNM stages I and II.
Eom DW, Kang GH, Han SH, Cheon GJ, Han KH, Oh HS, Kim JH, Jang HJ, Hong SM.
SourceDepartment of Pathology, University of Ulsan College of Medicine, Gangneung Asan Hospital, Korea. edwjyh@gnah.co.kr
Abstract
Micropapillary carcinoma (MPC) is an aggressive variant of adenocarcinoma, with a high incidence of lymph node (LN) metastasis in several organs, although not yet well described in the stomach. Thus, we compared the clinicopathologic characteristics, including survival data and immunohistochemical profiles of cell adhesion molecules (E-cadherin, β-catenin, IQGAP-1, and CD44v6), of MPCs with those of adenocarcinomas lacking MPC components (non-MPC) in the stomach. We compared 72 MPC cases with 160 non-MPC cases. Most gastric MPCs arose from tubular or papillary adenocarcinomas, and the proportion of MPC components ranged from 5% to 80%. MPCs were characterized by more frequent lymphovascular invasion and LN metastasis (P<0.0001), higher tumor node metastasis (TNM) stage (P=0.019), advanced age (>65 y; P<0.0001), and more frequent CD44v6 and aberrant β-catenin expression (P<0.0001). The overall 5-year survival rates for patients with MPC were significantly worse than those with non-MPC (30% vs. 67%; P=0.002). Furthermore, when it was stratified by TNM stages, the survival rates were distinguished between MPC and non-MPC groups in TNM stages I to II (P=0.0003), but not in TNM stages III to IV. The presence of the MPC component was associated with a significantly worse patient survival by univariate (P=0.0003) and multivariate (P=0.04) analyses in patients with stages I to II gastric carcinoma. In conclusion, recognition of the MPC component in gastric carcinoma is critical, because the MPC component is associated with more frequent LN metastasis and a worse prognosis, especially in stages I to II gastric cancer.
- The More We See, The Less We Know!
简单总结翻译如下（以1楼为主）
微乳头状癌（MPC）是一种侵袭性很强的腺癌，见于多种器官，易于淋巴结转移，本文比较72例MPC与160例非MPC，多数MPC伴发于管状或乳头状腺癌，多见于肿瘤深部浸润边缘，占肿瘤的5%-80%。结果显示，MPC更易发生淋巴管浸润和淋巴结转移（p<0.0001），TNM分期高（p=0.019），发病年龄大（>65岁，P<0.0001），更常表达CD44v6和发生β-catenin突变（p<0.0001），5年生存率低 (30% vs. 67%; P=0.002)。
第一篇文献说没有预后意义，第二篇说有
- The More We See, The Less We Know!
