【摘要】 目的：研究胃原发性绒毛膜癌的组织学特点，探讨其组织学的发生。方法：对１例残胃原发性绒毛膜癌进行尸检，组织学观察，应用免疫组织化学研究其组织学的发生。结果：肿瘤表现单一的绒毛膜癌形态伴有坏死和出血，肿瘤转移至肝脏、双肺及胃周围淋巴结。免疫组化肿瘤细胞表达ＨＣＧ阳性，部分肿瘤细胞表达ＣＫ阳性。在目前英文文献报道的４８例胃原发性绒毛膜癌中，２８．３％病例以单一的绒毛膜癌形态，１３％的病例胃为腺癌而转移灶为绒毛膜癌，５８．７％的病例为腺癌、低分化癌和绒毛膜癌。结论：胃原发性绒毛膜癌发生可能为：（１）腹部的异位性索，（２）性索绒毛膜癌的转移，（３）胃的畸胎瘤，（４）胃粘膜的多能干细胞分化癌变，（５）胃的腺癌或未分化癌细胞去分化。更多还原

【Abstract】 Purpose To investigate the clinicopathological characteristics and histogenesis of primary gastric choriocarcinoma. Methods One autopsy case of primary gastric choriocarcinoma was investigated at the light microscopic level, and was studied by immunohistochemical techniques. Results One type of choriocarcinoma was identified in this lesion and partially necrotic and hemorrhagic tumor tissue was found infiltrating and destoying the muscular coats of the stomach. Metastastic choriocarcinoma was found in liver, bilateral lungs and gastric lymph nodes. In the tumor, immunohistochemical stains showed human chorionicgonadotropin in choriocarcinoma cells, cytokeratin in the same cells. The 48 cases of primary gastric choriocarcinoma were accertained in the English literature, including the present case. In the primary tumor, 283% cases had only choriocarcinoma, 13% cases had only adenocarcinoma (choriocarcinoma was found in the metastatic lesion), 587% cases had adenocarcinoma or undifferentiated carcinoma and choriocarcinoma. Conclusions Several theories refer to the histogensis of primary choriocacinoma had been proposed: (1) Origin in an abdominally displaced gonad at anlage, (2) Long delayed metastasis from an intrauterine primary lesion, (3) Gastric teratoma origin, (4) Origin in a totipotential cell occurring in a gastric polyp, (5) retrodifferentiation of gatric adenocarcinoma.更多还原