Ueyama T, Nagai E, Yao T, Tsuneyoshi M
Second Department of Pathology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Am J Surg Pathol. 1993 Aug;17(8):813-9. doi: 10.1097/00000478-199308000-00006.
We studied 71 patients with solid-type gastric adenocarcinoma selected from 5,437 surgically resected specimens during the period from 1975 to 1988; six had vimentin-positive adenocarcinomas, and five of these were advanced. One was at an early stage. All six tumors showed the same histologic features and had either a diffuse or alveolar arrangement, with tumor cells having either poor or no cohesiveness. Many tumor cells were round to polygonal, with eosinophilic or clear cytoplasm and large, eccentric vesicular nuclei, as seen in malignant rhabdoid tumors of the kidney. In all cases, the cytoplasm showed coexpression of vimentin and cytokeratin as revealed by double immunostaining. Four of the five cases with advanced carcinoma died of the disease 1 to 6 months after surgery. The cases with vimentin-positive tumors had significantly poorer prognoses than those with vimentin-negative tumors. We also studied adenocarcinomas of various histologic types randomly selected from our file (160 intestinal type and 69 diffuse type of Lauren) but failed to detect any vimentin positive ones. These results indicate that vimentin is expressed in some of the solid-type adenocarcinomas, which have a poor prognosis, and indicating that rhabdoid-like cells may be found in a variety of adenocarcinomas of the stomach.
我们研究了1975年至1988年期间从5437例手术切除标本中选取的71例实性型胃腺癌患者；其中6例为波形蛋白阳性腺癌，5例为进展期，1例为早期。所有6例肿瘤均表现出相同的组织学特征，呈弥漫性或腺泡状排列，肿瘤细胞黏附性差或无黏附性。许多肿瘤细胞呈圆形至多边形，胞质嗜酸性或透明，核大、偏位、呈泡状，如同肾恶性横纹肌样瘤所见。所有病例中，双重免疫染色显示胞质同时表达波形蛋白和细胞角蛋白。5例进展期癌中有4例在术后1至6个月死于该疾病。波形蛋白阳性肿瘤患者的预后明显比波形蛋白阴性肿瘤患者差。我们还从存档病例中随机选取了各种组织学类型的腺癌（160例肠型和69例Lauren弥漫型）进行研究，但未检测到波形蛋白阳性病例。这些结果表明，波形蛋白在一些预后较差的实性型腺癌中表达，提示胃的各种腺癌中可能存在横纹肌样细胞。
