The Clinicopathological Features Of Gastric Cancer With Enteroblastic Differentiation

Background and purpose:Gastric cancer with Enteroblastic differentiation(GCED)is a newly discovered gastric adenocarcinoma.Recently,researchers have discovered that the tumor expresses embryonic stem cell marker SALL4 and known carcinoembryonic proteins(AFP and GPC3).The aim of this study was to investigate the clinicopathological features and molecular phenotypes of gastric cancer with enteroblast differentiation.Methods:Retrospective analysis of 337 cases of gastric adenocarcinoma diagnosed by pathology department of First Affiliated Hospital of Zhejiang University in March 2013-2017?Of them,8 cases were diagnosed as gastric carcinoma with intestinal blastocyte differentiation?According to the histopathological morphology,the immunophenotype was analyzed by immunohistochemistry,the SALL4 gene was detected by reverse transcription-polymerase chain reaction(RT-PCR),and the relevant literature was reviewed.Results:All the patients were aged,including 6 males and 2 females.The onset age was 68-83 years(mean 76.6 years).Microscopically,all cases had primitive enteroid structures,consisting of cubic or columnar cells with clear cytoplasm,and immunohistochemical staining showed AFP and GPC3 positive,or SALL4 positive.The expression of SALL4 mRNA was significantly increased by RT-PCR.Follow-up for 12 months to 5 years showed that 5 cases had liver and other organ metastasis,2 cases died,and 1 case survived without tumor.Conclusion:Gastric cancer with enteroblastoma differentiation is a rare invasive gastric adenocarcinoma with a worse prognosis than that of normal intestinal adenocarcinoma.The treatment of general intestinal adenocarcinoma has little effect.There are some characteristic changes in histology.It is helpful for diagnosis and differential diagnosis to be familiar with the tumor spectrum and genetic characteristics.The target therapy for the original marker,such as SALL4,has a bright future.