Lee Dakeun, Kim Young Chul, Lee Kee Myung, Yoon Joon-Kee, Kim Young-Bae
Department of Pathology, Ajou University School of Medicine, Suwon, Korea.
Department of Radiology, Ajou University School of Medicine, Suwon, Korea.
Cancer Res Treat. 2015 Jan;47(1):120-5. doi: 10.4143/crt.2013.137. Epub 2014 Aug 25.
Intramucosal gastric cancer (IGC) is associated with a very low risk of lymph node metastasis; thus it is the main candidate for minimally invasive surgical procedures, such as endoscopic submucosal dissection (ESD). Herein, we document an extraordinary case of IGC, which showed a very aggressive clinical course. A 66-year-old female underwent ESD for early gastric cancer. Histologically, the tumor consisted mainly of moderately differentiated adenocarcinoma measuring 1.6 cm in diameter, and the tumor was confined to the mucosa. Despite annual esophagogastroduodenoscopic follow-up, the tumor recurred, with wide metastasis to multiple lymph nodes and bones throughout the body after three years. Fluorescence in situ hybridization study demonstrated MET gene amplification as well as low grade polysomy 7 in both original and recurrent tumors. The clinical characteristics of metastatic IGCs and the implication of MET amplification are discussed.
黏膜内胃癌（IGC）发生淋巴结转移的风险极低；因此，它是诸如内镜黏膜下剥离术（ESD）等微创手术的主要适应证。在此，我们记录了一例特殊的IGC病例，其临床病程极具侵袭性。一名66岁女性因早期胃癌接受了ESD治疗。组织学检查显示，肿瘤主要由直径为1.6 cm的中分化腺癌组成，且肿瘤局限于黏膜层。尽管每年进行食管胃十二指肠镜随访，但三年后肿瘤复发，并广泛转移至全身多处淋巴结和骨骼。荧光原位杂交研究显示，原发肿瘤和复发肿瘤均存在MET基因扩增以及7号染色体低级别多倍体。本文讨论了转移性IGC的临床特征以及MET扩增的意义。
