胃と腸45巻12号

2010年11月発行

今月の主題 特殊型胃癌の病理像と臨床的特徴

主題

肝様腺癌―病理の立場から

著者： 岸本充¹

所属機関： ¹千葉大学大学院医学研究院病態病理

ページ範囲：P.1935 - P.1940

文献概要

要旨　肝様腺癌は肝細胞様形質を呈する高度悪性な腺癌の亜型の1つである．AFP産生腫瘍の代表的組織型であるが，AFP非産生性の場合もある．高分化ないし中分化な腺癌に類似する腺癌部と，肝細胞癌に類似する組織像を呈する肝様部とから成り，肝様部では，細胆管様構造，棘状小体，硝子球などが認められる．低分化充実性腺癌や原始腸管型腺癌などは，肝様の組織像の有無や肝細胞分化形質の同定により鑑別する必要がある．近年，細胆管様構造では膜輸送蛋白のMRPsが，腫瘍細胞ではglypican 3，PLUNC，SALL4などが陽性となると報告されている．肝様腺癌の発生機序は不明だが，ATBF1（AT motif binding factor 1）の機能喪失や，hepatocyte nuclear factor-4αやSALL4の異常発現などの関与が示唆されている．

参考文献

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