Zeng Xiangyu, Zhang Peng, Xiao Hua, Wu Xiuli, Liu Weizhen, He Jun, Gao Jinbo, Wang Guobin, Shuai Xiaoming, Tao Kaixiong
Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Department of Gastroduodenal and Pancreatic Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha 410013, China.
Oncotarget. 2017 Dec 21;9(2):2715-2725. doi: 10.18632/oncotarget.23595. eCollection 2018 Jan 5.
Intestinal hepatoid adenocarcinoma (IHA) is a very rare and unique intestinal malignancy. Due to the lack of case series specifically pertaining to IHA, the clinicopathological features and prognosis of it remain unclear.
Of the 42 patients enrolled in this study, 30 (71.4%) were male. Twenty-one cases (50.0%) were located in the colon. Eight cases (19.0%) had accompanying inflammatory bowel disease (IBD). Elevated serum alpha-fetoprotein (AFP) was detected for most patients (25/33, 84.8%). Twenty-five (59.5%) patients received complete resections. Vascular invasion (22/36, 61.1%), lymph node metastasis (28/36, 77.8%) and distant metastasis (21/42, 50.0%) were common. The 1-year progression-free survival (PFS) and disease-specific survival (DSS) of IHA were 26.9% and 30.6%, respectively. Multivariate analysis showed that only pTNM stage was an independent risk factor for PFS and DSS. PFS and DSS in patients with IHA were significantly lower than those with colorectal adenocarcinoma (CA) and hepatoid adenocarcinoma of the stomach (HAS).
IHA most commonly occurred in the colon and accompanied by IBD in several cases. pTNM stage was an independent factor for prognosis. The prognosis of IHA was significantly worse than that of CA and HAS.
Clinical data of IHA from four patients managed at our institution between January 2010 and December 2016, and 38 cases from research databases prior to 2017 were retrospectively studied.
肠道肝样腺癌（IHA）是一种非常罕见且独特的肠道恶性肿瘤。由于缺乏专门针对IHA的病例系列研究，其临床病理特征及预后仍不明确。
本研究纳入的42例患者中，30例（71.4%）为男性。21例（50.0%）位于结肠。8例（19.0%）伴有炎症性肠病（IBD）。大多数患者（25/33，84.8%）血清甲胎蛋白（AFP）升高。25例（59.5%）患者接受了根治性切除术。血管侵犯（22/36，61.1%）、淋巴结转移（28/36，77.8%）和远处转移（21/42，50.0%）很常见。IHA的1年无进展生存期（PFS）和疾病特异性生存期（DSS）分别为26.9%和30.6%。多因素分析显示，只有pTNM分期是PFS和DSS的独立危险因素。IHA患者的PFS和DSS显著低于结直肠癌（CA）和胃肝样腺癌（HAS）患者。
IHA最常发生于结肠，部分病例伴有IBD。pTNM分期是预后的独立因素。IHA的预后明显差于CA和HAS。
回顾性研究了2010年1月至2016年12月在我院接受治疗的4例IHA患者以及2017年之前研究数据库中的38例患者的临床资料。
