Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea.
Am J Surg Pathol. 2010 Aug;34(8):1139-46. doi: 10.1097/PAS.0b013e3181e7043b.
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.
胃微乳头状癌（MPC）是一种罕见的、新确认的实体瘤，仅有 2 例具有这种组织学特征的患者被报道。我们研究了 11 例胃 MPC 的临床病理特征、黏蛋白（MUC2、MUC5AC、MUC6、CD10）和细胞角蛋白（CK7 和 CK20）表达、表皮生长因子受体（EGFR 和 HER2）、预后标志物（p53 和 Ki-67）以及结局。MPC 成分的比例范围为 5%至 70%。微乳头状特征常出现在肿瘤的深部进展边缘。10 例（91%）中发现淋巴管内肿瘤栓子，4 例（36%）发现淋巴结转移。在 MPC 中，Ki-67（82%）、CK7（73%）、EGFR（64%）、p53（64%）、MUC5AC（45%）、MUC6（36%）和 CK20（27%）表达阳性。然而，所有病例的 MUC2、CD10 和 HER2 表达均为阴性。在 9 例常规腺癌和 11 例具有多个淋巴管内肿瘤栓子的乳头状腺癌中，Ki-67（100%）、CK7（90%）、EGFR（80%）、CK20（70%）、p53（70%）、MUC5AC（70%）、MUC6（60%）、MUC2（40%）、CD10（25%）和 HER2（15%）表达阳性。与 MPC 相比，对照组腺癌中 MUC2、CK20 和 Ki-67 标记指数的表达明显更高（P<0.05）。然而，其他临床病理特征和总体患者生存无显著差异。根据微乳头状成分的比例（截断值为 20%）将 MPC 分为 2 个亚组，未发现任何显著的临床病理差异（P>0.05）。尽管其他器官的 MPC 预后较差，但胃 MPC 似乎并非如此。需要进一步的大型研究来证实我们的初步发现。
