Zhang J X, Wang H, Ba X J, Li D, Wang Y, Liu P
Department of Pathology, Peking University First Hospital, Beijing 100034, China.
Laboratory of Electron Microscopy, Peking University First Hospital, Beijing 100034, China.
Zhonghua Bing Li Xue Za Zhi. 2021 Jan 8;50(1):21-25. doi: 10.3760/cma.j.cn112151-20200324-00251.
To investigate the clinicopathological characteristics of goblet cell adenocarcinoma (GCA) of the appendix. Seven cases of GCA were collected at the First Hospital of Peking University, Beijing, China from 2015 to 2018. Hematoxylin and eosin staining and immunohistochemical studies (EnVision method) were carried out on all cases. Three cases were examined using electron microscopy. Based on the review of 7 patients with GCA, the mean age of presentation for GCA of the appendix was 58 years with 2 men and 5 women, including 3 cases of grade 1, 3 cases of grade 2 and 1 case of grade 3 GCAs. Six GCAs had a prominent pattern of submucosal growth and lacked the formation of a well-defined tumor border. One of the 7 tumors was located in the distal segment of the appendix. Perineural involvement and lymphatic invasion were seen in 6 tumors and 1 tumor, respectively. Immunohistochemically, the tumor cells were diffusely or focally positive for chromogranin A, synaptophysin, CD56, cytokeratin, carcinoembryonic antigen, cytokeratin 20, MLH1, MSH2, MSH6 and PMS2, while the Ki-67 index ranged from 5% to 50%.The expression levels and positive cell numbers of p53 in high-grade GCAs were higher than those in low-grade GCAs. In the 7 patients with available follow-up information (14‒46 months), 1 patient died and the other 6 were alive at the end of the follow-up. GCA of the appendix is a rare neoplasm that shares histological features of both adenocarcinoma and carcinoid tumor. Its biological behavior ranges from indolent to highly aggressive.
探讨阑尾杯状细胞腺癌(GCA)的临床病理特征。2015年至2018年期间,在中国北京的北京大学第一医院收集了7例GCA病例。对所有病例进行苏木精-伊红染色和免疫组织化学研究(EnVision法)。3例进行了电子显微镜检查。基于对7例GCA患者的回顾,阑尾GCA的平均发病年龄为58岁,男性2例,女性5例,其中1级3例,2级3例,3级1例。6例GCA具有明显的黏膜下生长模式,缺乏明确的肿瘤边界。7例肿瘤中有1例位于阑尾远端。分别在6例和1例肿瘤中观察到神经周围侵犯和淋巴管侵犯。免疫组织化学显示,肿瘤细胞嗜铬粒蛋白A、突触素、CD56、细胞角蛋白、癌胚抗原、细胞角蛋白20、MLH1、MSH2、MSH6和PMS2呈弥漫性或局灶性阳性,而Ki-67指数范围为5%至50%。高级别GCA中p5³的表达水平和阳性细胞数高于低级别GCA。在7例有随访信息的患者中(14 - 46个月),1例患者死亡,其他6例在随访结束时存活。阑尾GCA是一种罕见的肿瘤,兼具腺癌和类癌肿瘤的组织学特征。其生物学行为从惰性到高度侵袭性不等。