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胃肝样腺癌的肝转移:一例报告及文献复习

Liver metastasis from hepatoid adenocarcinoma of the stomach: a case report and literature review.

作者信息

Zhu Hui, Li Qingqing, Qian Linqing

机构信息

Department of Radiology, Suzhou Wuzhong People's Hospital, Suzhou, China.

出版信息

Front Oncol. 2024 Jun 27;14:1297062. doi: 10.3389/fonc.2024.1297062. eCollection 2024.

Abstract

Hepatoid adenocarcinoma of the stomach (HAS) represents a rare malignant neoplasm sharing morphological and immunophenotypic similarities with hepatocellular carcinoma (HCC). Pathological morphology serves as the cornerstone for diagnosis, often accompanied by elevated alpha-fetoprotein (AFP) levels, nonspecific clinical symptoms, and imaging features reminiscent of gastric adenocarcinoma (GA). Liver metastases from HAS can mimic the enhancement patterns of HCC, posing challenges in differentiation from high-risk HCC cases. Conversely, HAS typically exhibits poorer prognostic outcomes compared to HCC and GA. This report presents a case of HAS with liver metastasis alongside a comprehensive literature review covering its pathology, molecular mechanisms, clinical presentations, and treatment modalities. Special focus is given to imaging characteristics and the utilization of radiomics for early-stage detection. The integration of imaging findings with laboratory results aids in HAS diagnosis, while radiomics provides novel insights for precise discrimination. In conclusion, the identification of distinct imaging markers distinguishing HAS from HCC and GA shows promise in facilitating optimal treatment strategies and improving patient outcomes.

摘要

胃肝样腺癌(HAS)是一种罕见的恶性肿瘤,在形态学和免疫表型上与肝细胞癌(HCC)相似。病理形态学是诊断的基石,常伴有甲胎蛋白(AFP)水平升高、非特异性临床症状以及类似胃腺癌(GA)的影像学特征。HAS的肝转移可模仿HCC的强化模式,在与高危HCC病例的鉴别上存在挑战。相反,与HCC和GA相比,HAS通常预后较差。本报告介绍了一例伴有肝转移的HAS病例,并对其病理、分子机制、临床表现和治疗方式进行了全面的文献综述。特别关注了影像学特征以及放射组学在早期检测中的应用。影像学结果与实验室结果相结合有助于HAS的诊断,而放射组学为精确鉴别提供了新的见解。总之,识别区分HAS与HCC和GA的独特影像学标志物有望促进优化治疗策略并改善患者预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eeed/11236608/db43b636bc93/fonc-14-1297062-g001.jpg

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