【摘要】 目的探讨胃富于淋巴间质的癌(GCLS)的临床病理特征及EB病毒感染情况、错配修复蛋白和人表皮生长因子受体-2(HER-2)表达情况,以期深入了解这一少见类型胃癌并对其分子分型和后续治疗提供病理依据。方法收集2013年3月至2021年3月浙江大学医学院附属杭州市第一人民医院收治的8例GCLS患者的临床资料。回顾性分析其临床和病理特征,采用免疫组化方法检测4种错配修复蛋白MLH1、PMS2、MSH2和MSH6以及HER-2表达情况,原位杂交法检测EB病毒编码的小RNA(EBER)表达情况,并对HER-2染色2+以上患者进行HER-2荧光原位杂交检测。结果 GCLS好发于中老年、男性、近端胃,多数患者呈膨胀性生长,少数患者可伴有腺体分化。8例中有6例EBER阳性,2例EBER阴性患者均错配修复蛋白表达缺失,为MLH1/PMS2表达缺失,1例EBER阳性患者同时HER-2过表达。结论 GCLS是一种形态上相似,但是分子分型不同的少见胃癌类型,对其进行更进一步的分子分型研究有助于更好了解其发生、发展及指导治疗。更多还原

【Abstract】 Objective To study the clinicopathological features and expression of Epstein-Barr virus(EBV), mismatch repair proteins and human epidermal growth factor receptor-2(HER-2) in gastric carcinoma with lymphoid stroma(GCLS).Methods The clinical and pathological characteristics of 8 cases of GCLS were analyzed, the expression of HER-2 and mismatch repair proteins MLH1, PMS2, MSH2, MSH6 and HER-2 were detected by immunohistochemistry, and the expression of Epstein-Barr virus encoded small RNA(EBER) was detected by in situ hybridization. The HER-2 fluorescence in situ hybridization was performed in cases with HER-2 staining above 2+. Results GCLS was likely occurred in older males and in proximal stomach, most of the cases showed expansive growth, few cases were accompanied by glandular differentiation. Six of the 8 cases were EBER positive, 2 EBER negative cases had mismatch repair protein MLH1/PMS2 expression deficiency, and 1 EBER positive case also had HER-2 overexpression. Conclusion GCLS is a rare type of gastric carcinoma with similar morphology but different molecular subtypes. Further molecular studies may better understand its development and guide its treatment.更多还原