肝樣胃癌的臨床病理特征預(yù)后及研究展望演示文稿

肝樣胃癌的臨床病理特征預(yù)后及研究展望演示文稿當(dāng)前第1頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)（優(yōu)選）肝樣胃癌的臨床病理特征預(yù)后及研究展望當(dāng)前第2頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)新生幼稚肝細(xì)胞（未分化完全）分泌AFP量很大

肝癌細(xì)胞（尚未分化的肝細(xì)胞）當(dāng)前第3頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)80-90%Hcc患者血清AFP增高肝細(xì)胞癌Hcc—90%肝外膽管細(xì)胞癌Hcc—10%原發(fā)性肝癌當(dāng)前第4頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)甲胎蛋白是診斷原發(fā)性肝癌的一個(gè)特異性臨床指標(biāo)。However!!EXCEPTION!!當(dāng)前第5頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)!!EXCEPTION!!部分肝硬化病人會(huì)長(zhǎng)期出現(xiàn)AFP達(dá)到上千，但多年都沒(méi)有肝癌的跡象。同時(shí)發(fā)現(xiàn)約20%的晚期肝癌病人，直至病故前，AFP仍不超過(guò)10。

AFP與腫瘤大小有一定的相關(guān)性，即腫瘤越小，陽(yáng)性率越低。AFP也與病理類(lèi)型相關(guān)，癌細(xì)胞分化I級(jí)和II級(jí)，AFP相對(duì)較低，Ⅲ級(jí)時(shí)相對(duì)較高。SomereportsshowedthatAFPcouldalsobeproducedbygastrointestinaltractorgans,rectalcarcinoma,gallbladdercarcinoma,lungcarcinoma,andbladdercancer.當(dāng)前第6頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)血清甲胎蛋白增高的原因

肝癌（陽(yáng)性率80-90%）隨著病情惡化它在血清中的含量會(huì)急劇增加

急性肝炎慢性肝炎肝硬化孕婦;其他腫瘤的肝轉(zhuǎn)移一過(guò)性升高隨著病情的恢復(fù)，血清甲胎蛋白值會(huì)下降

生殖細(xì)胞腫瘤陽(yáng)性率50%AFP陽(yáng)性當(dāng)前第7頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)alpha-fetoprotein-producinggastriccancer(AFPGC)Hepatoidadenocarcinomaofthestomach(HAS)當(dāng)前第8頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)Concept:

alpha-fetoprotein-producinggastriccancer(AFPPGC)Atpresenttime,itwasgenerallyacceptedthatthediagnosticcriteriaofAFP-producinggastriccancerwaspositivestainingofAFPinprimarylesionregardlessofserumAFPlevel當(dāng)前第9頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)ConceptofHAS1.Hepatoidadenocarcinomaisakindofextrahepatictumorpresentingmorphologicalareasidenticaltothatofhepatocellularcarcinomas.2.Inadditiontothehistologicalsimilarity,itcanalsoproduceAFP-likehepatocellularcarcinomas當(dāng)前第10頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)當(dāng)前第11頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)PatientsCharacteristics當(dāng)前第12頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)當(dāng)前第13頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)NoCorrelationAnalysis當(dāng)前第14頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)當(dāng)前第15頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)我們科室AFPPGC與對(duì)照胃癌患者的總生存比較當(dāng)前第16頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)當(dāng)前第17頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)當(dāng)前第18頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)當(dāng)前第19頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)當(dāng)前第20頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)當(dāng)前第21頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)當(dāng)前第22頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)49.2%11.5%75.6%當(dāng)前第23頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)當(dāng)前第24頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)AFPPGCandHAShadmoreaggressivebehaviorandpoorerprognosisthanCGC.HASirrespectiveofAFPproductionhaveapoorerprognosisthanAFP-producinggastriccarcinomaswithouthepatoiddifferentiationHASshouldbedistinguishedfromAFPPGC.Conclusion當(dāng)前第25頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)Why:HASmeanspoorprognosis?ItwasproposedthatsomesecretoryproteinslikeAFPhadimmunosuppressiveandprotease-inhibitoryproperties,thereforeenhancedinvasiveness.Theexactmolecularmechanismthatcouldexplainaggressivebehaviorwasstillnotclear.Somepreviousresearchesshowedthattheintegrityofhepatocytegrowthfactor(HGF)receptor(c-Met)andligandasHGFcouldregulatecellproliferationandmigration.Amemiyaetal.Foundthatc-Metover-expressedfrequentlyinAFP-producinggastriccancersthaninstage-matchedgastriccancersthatdidnotproduceAFP.TheseresultssuggestedthataggressivebehaviorofAFP-producinggastriccancermaybeassociatedwithover-expressedc-Met.Targetgeneofpoorbiologicalbehaviorandeasytolivermetastasis?當(dāng)前第26頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)AFPinclinicaluse:

CanAFPberoutinelycheckedincircularbloodandgastrictissuesbyIHC?CanAFPbeactedasabiomarkerofpoorprognosisandchemotherapyingastriccancer?當(dāng)前第27頁(yè)\共有28頁(yè)\編于星期三\13點(diǎn)O