Gurzu Simona, Banias Laura, Bara Tivadar, Feher I, Bara Tivadar, Jung Ioan
Department of Pathology, Clinical County Emergency Hospital, Tirgu-Mures. Romania.
Department of Surgery, University of Medicine and Pharmacy, Tirgu-Mures. Romania.
Recent Pat Anticancer Drug Discov. 2018;13(1):118-124. doi: 10.2174/2212798409666171101121108.
Metastases to the stomach are extremely rare and the metastatic pathway is not well understood.
To present two unusual gastric metastases and a review of the literature regarding the pathway of Epithelial Mesenchymal Transition (EMT) in the metastatic cells.
The clinicopathological aspects of the two cases were presented in the light of the most recent patents. Data about patents were obtained from the online databases PubMed, World Intellectual Property Organization (WIPO) and Google patents.
In the first case, in a 73-year-old female, total gastrectomy was performed for a Gastric Cancer (GC) that was proved to be, based on the immunohistochemical features (positivity for mammaglobin and estrogen receptor and negativity for E-cadherin, β-catenin, CD44 and maspin), a metastasis from an invasive lobular carcinoma of the breast, that was later confirmed. In the second case, a 67-year-old female with invasive ductal carcinoma of the breast, which benefited from chemotherapy and mastectomy, presented a metachronous gastric adenocarcinoma with collision-type metastatic breast ductal carcinoma. The aggressiveness of the GC cells was induced through the E-cadherin/maspin pathway, while the CD44-related stem-like properties of the tumor cells induced the aggressiveness of ductal carcinoma.
In females with breast cancer, a possible metastasis in the stomach should be taken into account. Maspin and VSIG1 are not involved in breast cancer histogenesis. The Wnt/β-catenin signaling is not involved in the lobular carcinoma progression. The CD44/HER2 positivity in ductal carcinoma cells might indicate high risk of distant metastasis and low response to chemotherapy.
胃转移极为罕见，其转移途径尚不清楚。
介绍两例不寻常的胃转移病例，并综述有关转移细胞上皮-间质转化（EMT）途径的文献。
根据最新专利介绍这两例病例的临床病理特征。有关专利的数据从在线数据库PubMed、世界知识产权组织（WIPO）和谷歌专利中获取。
第一例，一名73岁女性，因胃癌接受全胃切除术，根据免疫组化特征（乳腺珠蛋白和雌激素受体阳性，E-钙黏蛋白、β-连环蛋白、CD44和maspin阴性），证实为乳腺浸润性小叶癌转移，后来得到确认。第二例，一名67岁患有乳腺浸润性导管癌的女性，接受了化疗和乳房切除术，出现了异时性胃腺癌合并碰撞型转移性乳腺导管癌。胃癌细胞的侵袭性通过E-钙黏蛋白/maspin途径诱导，而肿瘤细胞的CD44相关干细胞样特性诱导了导管癌的侵袭性。
在患有乳腺癌的女性中，应考虑胃转移的可能性。Maspin和VSIG1不参与乳腺癌的组织发生。Wnt/β-连环蛋白信号通路不参与小叶癌的进展。导管癌细胞中的CD44/HER2阳性可能表明远处转移风险高和对化疗反应低。
