Liu Fang, Sun Ai-jing, Sun Li-ping, Chen Li-rong
Department of Pathology, Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou 310009, China.
Zhonghua Bing Li Xue Za Zhi. 2011 May;40(5):304-9.
To study the clinicopathologic features and immunophenotype of gastrointestinal adenocarcinomas with a micropapillary pattern differentiation (GAMPD).
Seventy-three cases of GAMPD arising in gastrointestinal tract were retrospectively reviewed. Immunohistochemical study for epithelial membrane antigen (EMA), insulin-like growth factor II mRNA-binding protein-3 (IMP3) and E-cadherin was performed.
Amongst the 73 cases studied, the micropapillary pattern accounted for 5% to 70% of the tumor component. It was often seen in a background of moderately differentiated adenocarcinoma. As compared with conventional adenocarcinoma, nodal metastasis was more frequently observed and the TNM tumor stage was statistically higher in GAMPD. The occurrence of micropapillary component in metastatic lymph nodes positively correlated with the proportion of micropapillary pattern in primary lesions. EMA staining on the stroma-facing surface of tumor micropapillae was demonstrated in 52.1% (38/73) of the cases. As compared with EMA-negative GAMPD, EMA-positive GAMPD was more in the stomach (P = 0.018), and with more metastatic lymph nodes (6.6 ± 5.8 vs 3.8 ± 4.7, P = 0.029). The rate of IMP3 expression in EMA-positive GAMPD was 86.8%(33/38), which was higher than that in conventional adenocarcinoma. In contrast, the rate of E-cadherin expression in GAMPD was lower than that in conventional adenocarcinoma.
GAMPD is a distinctive variant of gastrointestinal adenocarcinomas and different from conventional adenocarcinoma in tumor morphology, immunophenotype and biologic behavior. It carries an aggressive clinical course and poor prognostic outcome. Immunohistochemical study for EMA, IMP3 and E-cadherin would be helpful in the diagnosis and prognostic evaluation of GAMPD.
研究具有微乳头模式分化的胃肠道腺癌（GAMPD）的临床病理特征及免疫表型。
回顾性分析73例发生于胃肠道的GAMPD病例。进行上皮膜抗原（EMA）、胰岛素样生长因子II mRNA结合蛋白-3（IMP3）和E-钙黏蛋白的免疫组化研究。
在73例研究病例中，微乳头模式占肿瘤成分的5%至70%。常出现在中分化腺癌背景中。与传统腺癌相比，GAMPD中淋巴结转移更常见，TNM肿瘤分期在统计学上更高。转移淋巴结中微乳头成分的出现与原发灶中微乳头模式的比例呈正相关。73例病例中有52.1%（38/73）在肿瘤微乳头的基质表面出现EMA染色。与EMA阴性的GAMPD相比，EMA阳性的GAMPD更多见于胃（P = 0.018），且转移淋巴结更多（6.6±5.8对3.8±4.7，P = 0.
